作者：张一鸣1，张挺2，王飞2，张保中2，袁磊2

单位：

1.100053北京市，首都医科大学宣武医院神经外科　2.100088北京市，中国人民解放军火箭军特色医学中心神经外科

Units：

1.Department of Neurosurgery, Xuanwu Hospital Capital Medical University, Beijing 100053, China2.Department of Neurosurgery, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China

关键词：

颅骨成形术；钛网；并发症；钛网摘除；影响因素分析

Keywords：

Cranioplasty; Titanium mesh; Complications; Titanium mesh removal; Root cause analysis

CLC：

　R 651.1　

DOI：

10.12114/j.issn.1008-5971.2022.00.215

Funds：

国家自然科学基金青年基金项目（82001317）

摘要：

目的　分析钛网颅骨成形术后并发症发生情况及其影响因素。方法　选取2017年1月至2020年9月在中国人民解放军火箭军特色医学中心神经外科行钛网颅骨成形术的患者74例，通过医院病历系统及电话随访的方式获取患者的临床资料，包括一般资料、并发症发生情况及因并发症导致的钛网摘除情况。钛网颅骨成形术后患者发生并发症及钛网摘除的影响因素分析采用多因素Logistic回归分析。结果　本组患者钛网颅骨成形术后随访6~22个月，发生感染5例、帽状腱膜下积液3例、钛网暴露3例、排异反应1例、钛网移位1例、运动性失语1例，并发症发生率为18.9%（14/74）。本组患者因感染导致钛网摘除3例、因排异反应导致钛网摘除1例，钛网摘除发生率为5.4%（4/74）。多因素Logistic回归分析结果显示，年龄是钛网颅骨成形术后患者发生并发症〔OR =1.916，95%CI （1.047，3.507）〕和钛网摘除〔OR =1.141，95%CI （1.108，1.280）〕的独立影响因素（P ＜0.05）。结论　本组患者钛网颅骨成形术后并发症发生率为18.9%，钛网摘除发生率为5.4%。而年龄是钛网颅骨成形术后患者发生并发症和钛网摘除的独立影响因素。

Abstract：

　Objective　To analyze the complications after cranioplasty with titanium mesh and their influencingfactors. Methods　A total of 74 patients underwent cranioplasty with titanium mesh in the Department of Neurosurgery, PLARocket Force Characteristic Medical Center from January 2017 to September 2020 were selected. The clinical data of patientswere obtained by hospital medical record system and telephone follow-up, including general information, complications andtitanium mesh removal due to complications. Multivariate Logistic regression analysis was used to analyze the influencing factorsof complications and titanium mesh removal of patients after cranioplasty with titanium mesh. Results　The patients were followedup for 6-22 months after cranioplasty with titanium mesh, there were 5 cases of infection, 3 cases of subgaleal effusion, 3 cases oftitanium exposure, 1 case of rejection, 1 case of titanium dislocation and 1 case of motor aphasia, the complication rate was 18.9%(14/74) . Titanium mesh removal was found in 3 cases of infection and 1 case of rejection, the titanium mesh removal rate was 5.4%(4/74) . Multivariate Logistic regression analysis results showed that age was an independent influencing factor for complications[OR =1.916, 95%CI (1.047, 3.507) ] and titanium mesh removal [OR =1.141, 95%CI (1.108, 1.280) ] of patients after cranioplastywith titanium mesh (P < 0.05) . Conclusion　The complication rate and titanium mesh removal rate of patients after cranioplastywith titanium mesh was 18.9% and 5.4%, respectively. Age is an independent influencing factor for complications and titaniummesh removal of patients after cranioplasty with titanium mesh.

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