个体化超早期颅骨修补术在患者神经修复过程中的疗效观察

The effects of individualized ultra-early period skull neoplasty in the process of nerve restoring

目的探讨超早期颅骨修补术在患者神经功能修复过程中的作用及相关的不良反应,评价超早期颅骨修补治疗的可行性。方法选择2017年5月至2019年5月收治的行颅骨修补术患者64例,按修补术时间不同分为观察组和对照组。对照组32例,去骨瓣减压术后按传统时间(3~6个月内)行颅骨修补。观察组32例,术后超早期(1个月内)行颅骨修补。应用格拉斯哥昏迷(GCS)评分、残疾等级量表(DRS)、功能独立评定量表(FIM)对2组患者手术前、术后1个月、术后2个月、术后3个月的神经功能及生活质量进行评估;比较2组患者术后切口感染、切口裂开、皮下积液、脑脊液漏及新发癫痫等不良反应的发生率。结果2组患者GCS评分、DRS评分及FIM评分差异均有统计学意义(P<0.05);2组患者新发癫痫、切口感染、切口裂干、皮下积液和脑脊液漏等不良反应,差异无统计学意义(P>0.05)。结论行超早期颅骨修补术可显著改善患者的神经功能及生活质量,而相关不良反应无显著变化。

Objective To investigate the effects and related adverse reactions of individualized ultra-early period skull neoplasty in the process of nerve restoring,and to explore its feasibility.Methods A total of 64 patients who underwent cranioplasty in our hospital from May 2017 to May 2019 were enrolled in the study,who were divided into observation group and control group according to different repairing time,with 32 cases in each group.The patients in control group underwent cranioplasty in routine time(within 3~6 months)after decompressive craniectomy,however,the patients in observation group underwent skull repairing at ultra-early period after skull neoplasty(within 1 month).Glasgow Coma Scale(GCS),Disability Rating Scale(DRS)and Functional Independent Assessment Scale(FIM)were used to evaluate the neurological function and life quality of patients before operation,at 1m after operation,2m after operation and 3m after operation,respectively.Moreover the incidence rates of postoperative adverse reactions including incision infection,incision dehiscence,subcutaneous effusion,cerebrospinal fluid leakage and new epilepsy were observed and compared between the two groups.Results There were significant differences in GCS score,DRS score and FIM score between the two groups(P<0.05),however,there were no significant differences in related adverse reactions between the two groups(P>0.05).Conclusion The ultra-early period cranioplasty can significantly improve the neurological function and life quality of patients,without obvious adverse reactions.