外伤性颅骨缺损修复前、后局部脑血流变化的研究

The influence of cranioplasty on local cerebral blood flow in traumatic skull defect patients

目的探讨颅骨修补术对外伤性颅骨缺损患者脑血流动力学和神经症状的影响。方法对14例外伤性颅骨缺损患者颅骨修补前后多个时间点行脑SPECT检查,分别为术前、术后7d及术后10～24个月(平均1.5年)测量患者卧位时脑血流量,行手术前后自身对照分析,并且对其神经症状变化情况进行随访。结果术后18个月9例患者神经症状得到明显改善。患者行卧位SPECT检查发现颅骨修补术后7d局部脑血流量明显好于术前脑血流量,但5例患者术后10～24个月SPECT均发现相应部位脑血流量较术后7d和术前脑血流量有所下降。结论颅骨修补术后可改善脑血流量,同时有利于神经功能的恢复。

Objective To investigate the effect of cranioplasty on local blood flow and neurological symptoms of patients with traumatic skull defect.Methods Fourteen patients in whom craniotomy operations had been performed underwent a meticulous quantitative study of local blood flow,as assessed by SPECT in supine positions respectively before operation,one week and/or average 1.5 year after operation.We also analyzed neurological symptoms at the same time.Results The neurological symptoms of 9 patients were improved after cranioplasty.The local blood flow assessed by SPECT at supine position was improved significantly after cranioplasty,but decreased when 5 patients examination in average of 1.5 year after operation.Conclusions Cranioplasty could significantly improve regulating function of cerebral vessel,and then increase the cerebral blood flow.It could also benefit the restoration of brain function.