早期颅骨修补术对降低脑外伤患者脑积水发生率、神经功能缺损、日常生活能力影响的研究

Effect of Early Cranioplasty on Reducing Hydrocephalus,Neurological Deficits and Activities of Daily Living in Patients with Traumatic Brain Injury

目的 对脑外伤患者应用早期颅骨修补术,分析其对降低患者脑积水发生率及神经功能缺损及日常生活能力的影响.方?法 选取江苏省涟水县人民医院2016年7月至2019年7月收治的脑外伤患者50例,以抽签法将其分为对照组与实验组,每组各25例.对照组行脑室腹腔引流手术,实验组在此基础上加行早期颅骨修补术,对比两组手术前后患者的神经功能缺损程度及日常生活能及手术后出现脑积水的发生率、并发率,以及手术前后两组患者的认知功能指标评分、白细胞介素-6(IL-6)及肿瘤坏死因子(TNF-α)和血管内皮生长因子的含量.结果 术前2组患者的神经功能缺损程度及日常生活能力比较,差异无统计学意义(P> 0.05);术后实验组患者神经功能缺损的程度及日常生活能力和术后出现脑积水的发生率均比对照组理想,组间比较差异有统计学意义(P<0.05);术后实验组的并发率低于对照组(P<0.05);术前2组患者的FLM评分、NCSE评分、IL-6、TNF-α及血管内皮生长因子的含量比较无显著差异(P>0.05);术后5?d实验组功能独立性评价量表(FLM)评分、神经行为认知状况测试表(NICSE)评分、IL-6、TNF-α及血管内皮生长因子的含量均优于对照组,组间比较差异有统计学意义(P<0.05).结论 对脑外伤患者而言,在早期进行颅骨修补术能够促进神经功能的恢复,降低出现脑积水的概率及并发症的发生率,提高患者治疗效果及日常生活能力.

Objective To analyze the effects of early cranial repair on patients with traumatic brain injury to reduce the incidence of hydrocephalus,neurological deficits and daily living ability.Methods A total of 50 cases of patients with brain trauma admitted to the people's hospital of lianshui county,jiangsu province from July 2016 to July 2019 were selected and divided into the control group and the experimental group by lottery,with 25 cases in each group.Control line ventricle peritoneal drainage operation,the experimental group on the basis of this,early surgical repair of skull,compared two groups of patients before and after operation of nerve function defect degree and the daily life and the incidence of hydrocephalus after surgery,the concurrent rate,as well as the two groups before and after operation in patients with cognitive function index score,interleukin 6(IL-6)and tumor necrosis factor(TNF-α)and vascular endothelial growth factor levels.Results Before surgery,there was no significant difference in the degree of neurological deficits and daily living ability between the two groups of patients(P>0.05).After surgery,the degree of neurological deficits and daily living ability and hydrocephalus occurred after surgery in the experimental group.The incidence rate was better than the control group,and the difference between the groups was statistically significant(P<0.05).After surgery,the concurrency rate in the experimental group was lower than that in the control group(P<0.05);before surgery,the FLM and NCSE of the two groups of patients Scores,interleukin-6,tumor necrosis factor,and serum endothelin content were not significantly different(P>0.05);five days after surgery,the FLM and NCSE scores of the experimental group,interleukin-6,and tumors The levels of necrosis factor and serum endothelin were better than those in the control group,and there was statistical significance between the groups(P<0.05).Conclusion For patients with traumatic brain injury,craniotomy is performed at an early stage to promote the recovery of nerve function,reduce the probability of hydrocephalus and complications,and improve the treatment effect and ability of daily life.