早期颅骨修补术治疗颅脑外伤术后颅骨缺损的有效性及安全性

Effectiveness and Safety of Early Skull Repair in the Treatment of Patients with Skull Defects After Craniocerebral Trauma

目的研究在颅脑外伤患者术后颅骨缺损早期实施颅骨修补术的有效性及安全性。方法选择2018年7月~2020年11月在我院接受手术治疗的82例颅脑外伤患者作为研究对象,根据颅骨修补术的实施时间分为早期组和常规组,各41例。常规组在去骨瓣减压术实施3个月后待患者病情稳定进行颅骨修补,早期组则在去骨瓣减压术实施3个月内进行颅骨修补;比较两组神经功能、MCA血液流速、生存质量、临床疗效及并发症发生情况。结果早期组NIHSS评分低于常规组,差异有统计学意义(P<0.05);早期组术后缺损侧MCA血液流速、KPS评分、ADL评分均高于常规组,ZPS评分低于常规组,差异有统计学意义(P<0.05);早期组治疗总有效率高于常规组(92.68%vs 78.05%),差异有统计学意义(P<0.05);早期组并发症发生率低于常规组(4.88%vs 21.95%),差异有统计学意义(P<0.05)。结论在颅脑外伤患者术后颅骨缺损早期实施颅骨修补术的疗效较高,可减轻患者神经功能损伤,改善患侧动脉血液循环,有助于提升患者生存质量,且安全性较高。

Objective To study the effectiveness and safety of early cranioplasty in patients with craniocerebral trauma.Methods A total of 82 patients with craniocerebral trauma who underwent surgical treatment in our hospital from July 2018 to November 2020 were selected as the research objects.According to the implementation time of the cranioplasty,they were divided into an early group and a routine group,with 41 cases in each group.In the routine group,the skull repair was performed after the decompressive craniectomy was performed 3 months after the patient's condition was stable,and in the early group,the skull repair was performed within 3 months of the decompressive craniectomy.The nerve function,MCA blood flow rate,quality of life,clinical efficacy and complications were compared between the two groups.Results The NIHSS score of the early group was lower than that of the conventional group,the difference was statistically significant(P<0.05);The MCA blood flow rate,KPS score,and ADL score on the defect side of the early group were higher than those of the conventional group.The ZPS score was lower than that of the conventional group,the difference was statistically significant(P<0.05);The total effective rate of treatment in the early group was higher than that in the conventional group(92.68%vs 78.05%),the difference was statistically significant(P<0.05);The incidence of complications in the early group was lower than that in the conventional group(4.88%vs 21.95%),the difference was statistically significant(P<0.05).Conclusion Early cranioplasty in patients with craniocerebral trauma has a high curative effect.It can reduce the patient's nerve damage,improve the blood circulation of the affected arteries,and help improve the quality of life of patients with high safety.