早期修补脑外伤术后颅骨缺损的临床效果

Clinical effect of early repair of skull defect after traumatic brain injury

目的探讨早期颅骨修补对脑外伤术后颅骨缺损患者的临床疗效。方法选择2015年9月～2017年9月我院收治的50例脑外伤开颅术后颅骨缺损患者,采用随机数字表法将其分为早期组和常规组,每组各25例。常规组患者在开颅去骨瓣减压术后3～6个月行颅骨修补术,早期组则在开颅去骨瓣减压术后40 d～3个月内行颅骨修补术。比较两组患者术后3个月的格拉斯哥预后(GOS)评分,并观察两组患者神经功能缺损的改善情况以及术后并发症发生情况。结果早期组的治疗总有效率为88.00%,高于常规组的76.00%,差异有统计学意义(P<0.05)。两组患者术前的神经功能缺损程度CSS评分比较,差异无统计学意义(P>0.05)。两组术后的CSS评分均有所降低(P<0.05),且早期组患者的CSS评分低于常规组,差异有统计学意义(P<0.05)。两组患者的术后并发症总发生率比较,差异无统计学意义(P>0.05)。结论脑外伤术后颅骨缺损患者在术后3个月内早期进行颅骨修补治疗,能促进患者神经功能缺损的恢复,更好地改善患者的预后,且安全性良好,值得临床进一步研究。

Objective To investigate the clinical efficacy of early skull repair on patients with skull defect after traumatic brain injury. Methods A total of 50 patients with skull defects after craniotomy were enrolled in our hospital from September 2015 to September 2017. The patients were divided into the early group and the regular group by a random number table method, with 25 cases in each group. In the regular group, the skull repair was performed 3-6 months after decompressive craniectomy, while in the early group, decompressive craniectomy was performed from 40 days to 3 months. The Glasgow outcome scale (GOS) scores were compared between the two groups at 3 months after surgery. The improvement of neurological deficits and postoperative complications were observed in the two groups. Results The total effectiveness rate in the early group was 88.00%, which was higher than that 76.00% in the regular group, with statistical difference (P<0.05). There was no significant difference in the preoperative neurological deficit degree expressing as China stroke scale (CSS) score between the two groups (P>0.05). The CSS scores of the two groups decreased after surgery (P<0.05), and the CSS score of the early group was lower than that of the regular group, with significant difference (P<0.05). There was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05). Conclusion Skull repair in patients with skull injury after brain trauma can improve the recovery of neurological deficits in patients and the prognosis in good safety, which is worthy of further clinical research.