早期颅骨修补术对降低脑外伤患者脑积水发生率的影响

Effect of Early Cranioplasty on the Incidence of Hydrocephalus in Patients with Traumatic Brain Injury

目的观察早期颅骨修补术对降低脑外伤患者脑积水发生率的影响。方法选取2015年1月至2016年12月我院收治的重型颅脑损伤患者75例,随机分为研究组与对照组。两组患者均实施颅骨修补术治疗,对照组35例进行颅骨修补手术的时间为初次减压术后的2个月后,研究组40例进行颅骨修补手术的时间为初次减压术后的2个月内。比较两组患者的神经功能缺损程度和日常生活能力评分,并比较两组患者的脑积水发生率。结果术前两组患者的神经功能缺损程度与日常生活能力评分比较差异无统计学意义(P>0.05);术后,两组患者的神经功能缺损程度和日常生活能力评分均明显改善,且研究组评分显著优于对照组,差异具有统计学意义(P<0.05)。研究组的术后脑积水发生率为5.00%(2/40),显著低于对照组的22.86%(8/35),差异具有统计学意义(P<0.05)。结论初次减压术后2个月内实施早期颅骨修补术能够显著改善患者的神经功能缺损程度和日常生活能力,降低术后脑积水发生率,值得临床推广。

Objective To observe the effect of early cranioplasty on the incidence of hydrocephalus in patients with traumatic brain injury. Methods 75 cases of patients with severe traumatic brain injury admitted to our hospital from January 2015 to December 2016 were selected, and randomly divided into the study group and the control group. 35 cases of control group received cranioplasty at 2 months later after first decompression, while 40 cases of study group received cranioplasty within 2 months after first decompression. The score of degree of neural function defect, score of activities of daily living and incidence of postoperative hydrocephalus were compared between two groups. Results Before surgery, no statistical difference was found between two groups in the score of degree of neural function defect or score of activities of daily living （P 〉0.05）; After surgery, both groups had significantly improved score of degree of neural function defect and score of activities of daily living, and the study group was superior to the control group in two indicators （P 〈0.05）. The incidence of postoperative hydrocephalus of study group was 5.00% （2/40）, significantly lower than 22.86% （8/35） of control group, with statistically significant difference （P 〈0.05）. Conclusions Early cranioplasty within 2 months after first decompression can significantly improve patients＇ degree of neural function defect and activities of daily living, and reduce the incidence of postoperative hydrocephalus, which is worthy of clinical promotion.