颅骨修补对脑血流和认知功能的临床观察

Clinical observation on cerebral blood flow and cognitive function after cranioplasty

目的观察颅骨修补术后病人脑血流量的变化及认知功能。方法 35例右侧半球颅骨修补术病人,术前4～5d行CT薄层平扫、CT灌注扫描,术后10d再行相同的头位置和扫描参数的CT脑灌注扫描。取双侧大脑皮层为观察记录点,分别记录术前、术后灌注CT相关区域脑组织的局部脑血容量(rCBV)、局部脑血流量(rCBF)、平均通过时间(MTT)和到达峰值时间(TTP)值。术前及术后1个月均行蒙特利尔(MoCA)认知评估。结果术后1月患者rCBF、rCBV、MTT和TTP等灌注参数较术前有明显变化,具有统计学意义(P<0.05)。术后1个月MoCA认知功能评估结果也显示在记忆、计算等功能有所改善,平均MoCA得分从17.4分上升为24.2分。结论颅骨修补手术后脑血流量增加、血流通过速度加快,认知功能在记忆、计算等功能均有所改善。

Objective To observe the change of cerebral blood flow and cognitive function of patients after cranioplasty. Methods A total of 35 patients who had undergone eranioplasty on their right side skulls were taken as samples. The 4- 5 d line CT thin layer plain scanning and CT perfusion scanning were conducted on the patients before the operation, and CT cerebral perfusion scanning was conducted 10 days after the operation at the same head position using the same scanning parameters. The cerebral cortexes on both sides were taken as the observation and recording points to record the rCBF, rCBV, MTT, and TTP values of brain tissues in perfusion CT related areas both before and after the operation. Results Obvious change was seen in the rCBF, rCBV, MTT, and TTP values of the patients one month after the operation, and they were therefore of statistical significanee（P〈0. 05）. Furthermore, the result of MoCA cognitive function assessment also indicated improvement in functions like memory and calculation, with the average MoCA score increased from 17.4 to 24. 2. Conclusion Both the blood flow volume and blood flow velocity of the afterbrain increased,and the cognitive functions like memory and calculation improved after eranioplasty.