Ⅱ期颅骨成形实施时间对颅骨缺损患者预后的影响

Influences of the enforcing time of stageⅡcranioplasty on prognosis of skull defeci patients

目的探讨Ⅱ期颅骨成形实施时间对脑外伤颅骨缺损患者的影响,分析实施早期颅骨成形的优越性。方法回顾性分析2004年4月—2010年6月因脑外伤后遗留颅骨缺损采用钛网行颅骨成形术59例的临床资料,其中在颅骨缺损后1～2月行颅骨成形31例,在颅骨缺损后3～6月行颅骨成形28例。对出院时患者的症状、并发症及出院6个月后患者钛网修补的疗效和日常生活运动能力进行评估。结果早期组患者症状缓解率为83.87%,常规组患者症状缓解率为60.71%,二者相比差异有统计学意义(P<0.05);两组患者钛网修补的疗效均为优;早期组患者在ADLⅠ～Ⅱ级方面优于常规组,差异有统计学意义(P<0.05)。结论脑外伤后颅骨缺损的早期颅骨成形有助于患者症状的缓解、神经功能的康复、日常生活运动能力的提高,所以,在无颅内感染及高颅压的情况下,应尽早对颅骨缺损患者实施颅骨成形术。

Objective To study the influences of the enforcing time of stage II cranioplasty on skull defeci patients after cerebral trauma and analysis on superiority in early stage cranioplasty. Methods A retrospective study was done on data of 59 cases with titanic mesh eranioplasty to skull defeei after head injury from April 2004 to October 2010 June, which were operated 1 to 2 months after skull defeci in 31 cases, 3 to 6 months after skull defeci in 28 cases. To assess the symptoms when patients leaving hospital, complications, curative effect of titanic mesh and the vital motor function of daily life 6 months after leaving hospital. Results The remissive rate of early treatment group was 83.87%, control group was 60.71%, the difference has statistical significance （ P 〈 0.05 ）. Both of the curative effects in titanic mesh of the two groups were high quality. Early treatment group was better than control group in ADL I - II, the difference has statistical significance （ P 〈 0.05 ）. Conclusion Early stage cranioplasty to skull defeci patients cerebral trauma is conducive to ease symptoms, functional rehabilitation of nerve and improve the vital motor function of daily life. So the early stage cranioplasty ought to be done as early as possible without intracranial infection and hypertension.