2020 年第 7 期 第 15 卷

聚维酮碘冷冻保存颅骨骨瓣与新鲜颅骨骨瓣的力学特性研究

Study on frozen preservation of autologous cranial bone flap with povidone iodine and fresh bone flap

作者：庄明华罗成

英文作者：Zhuang Minghua Luo Cheng

单位：汕头大学医学院第一附属医院神经外科515041 

英文单位：Department of Neurosurgerythe First Affiliated Hospital of Shantou University Medical College， Shantou 515041， China

关键词：去骨瓣减压术；聚维酮碘冷冻保存；自体颅骨骨瓣；力学研究

英文关键词：Decompressivecraniectomy；Povidoneiodinecryopreservation；Autologousskullflap；Mechanicsresearch

• 摘要：

• 目的探讨聚维酮碘冷冻保存颅骨骨瓣与新鲜颅骨骨瓣和铸铁模型标准件的力学特性。方法5份新鲜颅骨骨瓣来自于2019年5—7月在汕头大学医学院第二附属医院神经外科和汕头市中心医院神经外科行去骨瓣减压术的5例患者（新鲜骨瓣组），均为遗弃骨瓣；5份聚维酮碘冷冻保存颅骨骨瓣来自于2009年8月至2013年9月汕头大学医学院第一附属医院拟行自体颅骨骨瓣回植颅骨修补术患者（保存骨瓣组），因患者死亡未行自体颅骨骨瓣回植颅骨修补术。铸铁模型标准件由汕头大学土木工程系力学实验室提供。采用摆锤实验测试新鲜骨瓣、保存骨瓣和铸铁模型标准件的单位截面积承受冲击力峰值及单位截面积承受压力实验的峰值，并观察保存骨瓣的形态学外观。结果新鲜骨瓣和保存骨瓣单位截面积承受压力峰值比较差异无统计学意义［（2 377±1 454）N/mm2比（2 358±723）N/mm2］（t=0.021，P=0.984）。保存骨瓣组、铸铁模型的单位截面积承受摆锤冲击力峰值均高于新鲜骨瓣组［（0.037±0.014）、（0.031±0.003）J/mm2比（0.014±0.006）J/mm2］（P=0.013、0.044），保存骨瓣组与铸铁模型标准件比较差异无统计学意义（P=0.682）。聚维酮碘冷冻保存的颅骨骨瓣外板、内板均没有明显改变，形态学外观与新鲜骨瓣无明显差异。结论聚维酮碘冷冻保存颅骨骨瓣形态学和力学测试均未发生明显改变，采用自体颅骨保存骨瓣回植修补颅骨缺损是一种可靠、安全、便捷的方法。

• ObjectiveTo compare the characteristics between fresh cranial bone flap and preserved cranial bone flap using special povidone iodine liquid cryopreservation. Methods Five fresh cranial bone flaps were derived from patients who received decompressive craniectomy from May to July 2019 in neurosurgery departments of the Second Affiliated Hospital of Shantou University Medical College and Shantou Central Hospital(fresh cranial bone group). Other five bone flaps were removed from patients who failed to survive and did not receive skull defect repair(preserved bone flap). These were preserved in povidone iodine cryopreservation solution in the First Affiliated Hospital of Shantou University Medical College. Cast iron models were provided by mechanics laboratory of civil engineering department of shantou university. Pendulum striking experiment was used to test and evaluate the characteristics among fresh, preserved cranial bone flap and cast iron models. Results  There was no difference between fresh bone flaps［（2 377±1 454）N/mm2］ and preserved bone flaps［（2 358±723）N/mm2］ regarding the peak pressure of bone flap（t=0.021，P=0.984）. The pendulum striking experiment tested the maximum stress on bone flap per unit cross-sectional areain  fresh cranial bone group and cast iron models  were higher than those in fresh cranial bone group［（0.037±0.014）,（0.031±0.003）J/mm2 vs （0.014±0.006）J/mm2 P=0.013, 0.044］. The appearances (including the inner and outer plates of the skull) of bone flaps preserved by povidone-iodine cryopreserved showed no changes，and there was no obvious difference in morphological appearance from fresh bone flaps. Conclusions  The autologous cranial bone flap preserved by special povidone iodine cryopreservation is not changed by morphological and mechanical tests. It is a reliable, safe and convenient method to repair the skull defect with autologous cranial bone flap.