聚醚醚酮材料在大骨瓣去除术后颅骨修补患者中的临床应用

目的探讨聚醚醚酮材料（PEEK）在大骨瓣缺损患者颅骨修补术中的应用及临床疗效。方法回顾性分析上海交通大学医学院苏州九龙医院神经外科2018年10月—2021年9月收治的48例大骨瓣减压术后行颅骨修补术的患者的临床资料，其中PEEK材料修补的PEEK组共21例，三维钛网修补的钛网组共27例，分析两组手术材料费用，术后并发症发生率，手术时间，塑形满意度等方面的差异。结果所有患者均康复出院，未出现术后感染，植入物裸露，癫痫等并发症。PEEK组皮下积液发生率、手术材料费用和塑形满意度明显高于钛网组；手术时间、术后气颅发生率、颅内出血发生率两组间无明显差异。PEEK组患者中有3例患者出现大量皮下积液，有1例大量皮下积液患者出现对侧肢体肌力下降，经抽吸及加压包扎后康复出院。结论PEEK材料可安全有效地应用于颅骨修补术，能够完美恢复颅骨的解剖结构，不影响术后CT检查；但价格昂贵，需根据患者个体情况选用。

Objective To explore the application and clinical effects of polyetheretherketone(PEEK) in cranioplasty of patients with large bone flap defect. Methods The clinical data of 48 patients who underwent cranioplasty after large bone flap removal in the Department of Neurosurgery, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine from October 2018 to September 2021 were analyzed retrospectively, including 21 cases in PEEK group and 27 cases in titanium mesh group. The differences between the two groups in the cost of surgical materials, the incidence of postoperative complications, operation time and plastic surgery satisfaction were analyzed. Results All patients recovered and discharged without complications such as postoperative infection, implants exposure, epilepsy. The incidence of subcutaneous effusion, surgical material cost and plastic surgery satisfaction in PEEK group were significantly higher than those in titanium mesh group; There was no significant difference in operation time, incidence of postoperative pneumocranium and incidence of intracranial hemorrhage between the two groups. 3 patients in PEEK group had a large amount of subcutaneous effusion, and 1 patient with large amount of subcutaneous effusion experienced a decrease in muscle strength of contralateral limb. Finally the patient recovered and was discharged from the hospital after suction and compression bandaging.Conclusions PEEK material can be used safely and effectively in cranioplasty, which can perfectly restore the anatomical structure of the skull without affecting the postoperative CT examination. However, the price is expensive, and it is still not widely used.