重型颅脑外伤去骨瓣减压术后早期颅骨成形术对患者早期、远期效果分析

Effect analysis on patients with early, long-term of severe brain trauma after decompressive craniectomy early cranioplasty

目的：探讨重型颅脑外伤去骨瓣减压术后早期颅骨成形术对患者早期、远期影响。方法选取2010年12月~2013年12月我院接诊治疗的重型颅脑外伤患者共76例，将患者分为两组，观察组38例，去骨瓣减压术后4~8周行颅骨成形术，对照组38例，去骨瓣减压术后4~6个月行颅骨成形术，比较两组早期疗效及远期疗效、并发症发生情况。结果成形术后4周观察组神经功能缺损评分与对照组比较较低，Barthel评分、Fugl-Meyer评分与对照组比较较高，差异有统计学意义（P〈0.05）。成形术后2个月、成形术后12个月观察组GCS评分、GOS评分、生活质量自评分与同期对照组比较均较高，差异有统计学意义（P〈0.05）。观察组并发症总发生率与对照组比较较低，差异有统计学意义（P〈0.05）。结论重型颅脑损伤去骨瓣减压术后早期颅骨成形术早期、远期临床效果显著，安全有效，可在临床推广应用。

Objective To investigate the early, long-term effect of the craniectomy severe traumatic brain injury of early postoperative cranial decompression angioplasty patients. Methods A total of 76 cases with severe traumatic brain in-jury patients were selected from December 2010 to December 2013 in our hospital for treatment, they were divided into two groups, 38 cases in the observation group, which were treated with decompressive craniectomy after 4 to 8 weeks cranioplasty, 38 cases in the control group and the patients were treated with craniectomy 4 to 6 months postoperative cranioplasty. The early efficacy and long-term efficacy, complications occur of two groups were compared. Results The neurological function four weeks after the forming of the observation group was lower than the control group, Barthel score, Fugl-Meyer score were higher than the control group, the difference was statistically significant （P〈0.05）. GCS score, GOS score, quality of life scores of 2 months and 12 months after angioplasty of the observation group were higher than the control group on the same period, the difference was statistically significant （P〈0.05）. The overall incidence of complications in the observation group was lower than the control group, the difference was statistically significant （P〈0.05）. Conclusion Early, long-term clinical results of severe brain injury early decompressive craniectomy after cranio-plasty are obvious, safe and effective, can be popularized in clinical application.