早期颅骨修补术对脑外伤患者临床疗效及不良反应的影响

Effect of early cranioplasty on clinical efficacy and adverse reactions in patients with trau-matic brain injury

目的探讨早期颅骨修补术对脑外伤患者临床疗效及不良反应的影响。方法选取2020-03至2022-03于医院治疗的脑外伤恢复期合并颅骨缺损患者98例,根据去骨瓣减压术后颅骨修补手术时机分为两组,对照组术后6个月后行颅骨修补术,研究组术后3个月内行颅骨修补术,观察对比两组患者术后的不良反应发生率、认知功能、神经功能、日常生活能力、生活质量改善程度。结果研究组不良反应发生率(6.12%)低于对照组(24.48%)(P<0.05);研究组术后NIHSS评分(11.20±2.65)低于对照组(15.41±2.62),MMSE评分(27.02±1.77)高于对照组(20.33±2.46),BI评分(84.08±6.28)高于对照组(71.61±7.42),差异均有统计学意义(P<0.05)。研究组术后KPS、GOS评分均高于对照组(P<0.05)。结论早期颅骨修补术能有效改善患者的认知、神经功能,减少不良反应,改善患者预后。

Objective To analyze the effect of early cranioplasty on clinical efficacy and adverse reactions in patients with traumatic brain injury.Methods Ninety-eight patients with traumatic brain injury complicated with skull defect treated in Beijing Rehabilitation Hospital of Capital Medical University from March 2020 to March 2022 were divided into two groups according to the timing of cranioplasty after decompressive craniectomy.Cranioplasty was performed 6 months after operation in the control group and within 3 months after operation in the study group.The incidence of postoperative adverse reactions,cognitive function,neurological function,activities of daily living and quality of life were observed and compared between the two groups.Results The total incidence of adverse reactions in the study group(6.12%)was lower than that in the control group(24.48%).After treatment,the NIHSS score of the study group was lower than that of the control group(15.41±2.62),and the MMSE score of the study group was higher than that of the control group.BI score(84.08±6.28)was higher than that of the control group(71.61±7.42).The scores of social function,physical function,material life and psychological function in the study group were higher than those in the control group,and the scores of KPS and GOS in the study group were higher than those in the control group after treatment.Conclusions Early cranioplasty can effectively improve the cognitive and neurological function of patients,reduce the adverse reactions and improve the prognosis of patients.