去骨瓣减压术后超早期颅骨修补术对患者预后的影响分析

Effect Analysis of Ultra Early Cranioplasty After Decompressive Craniectomy on Prognosis of Patients

目的探讨去骨瓣减压术后超早期颅骨修补术对患者预后的影响。方法随机选择盐城市大丰人民医院2018年1月-2019年12月接收的68例实施去骨瓣减压术患者,采用随机数字表法进行分组,每组34例。对照组于去骨瓣减压术后3~6个月实施颅骨修补术;观察组于术后6~8周进行颅骨修补术治疗,对两组治疗效果进行对比。结果两组Barthel评分、GCS评分和MMSE评分在颅骨修补术前未见明显差异(P>0.05);颅骨修补术后,观察组上述评分更高,与对照组相比存在明显差异(P<0.05);并发症发生率方面,观察组(5.88%)较对照组(23.53%)低,差异有统计学意义(P<0.05)。情感职能、生理职能、社会功能、生理功能、躯体疼痛、精神健康、活力和总体健康评分方面,观察组均比对照组高,差异有统计学意义(P<0.05)。治疗后,KPS评分、术中出血量及皮瓣分离时间方面,观察组比对照组优(P<0.05)。结论超早期颅骨修补术在去骨瓣减压术后应用效果明显,除增强患者认知功能及日常生活能力外,能够尽量避免并发症的发生,确保良好的治疗效果,值得采纳与推广。

Objective To investigate effect of ultra early cranioplasty after decompressive craniectomy on prognosis of patients.Methods The paper chose 68 patients with decompressive osteotomy in Yancheng City Dafeng people's Hospital from January 2018 to December 2019,and divided them into groups randomLy by random number table method,with 34 cases in each group.Control group was treated with skull repair 3~6 months after decompressive craniectomy;observation group with skull repair 6~8 weeks after operation.Curative effect between two groups was compared.Results There was no significant difference in Barthel scores,GCS scores and MMSE scores between two groups before cranioplasty(P>0.05).After skull repair,above scores in observation group were higher than control group(P<0.05).Incidence of complications in observation group(5.88%)was significantly lower than control group(23.53%)(P<0.05).Scores of emotional function,physiological function,social function,physiological function,physical pains,mental health,vitality and overall health in observation group were higher than control group(P<0.05).After treatment,KPS scores,intraoperative bleeding volume and flap separation time in observation group were better than control group(P<0.05).Conclusion Ultra early cranioplasty can achieve obvious application effect after decompressive craniectomy,can enhance cognitive function and daily living ability of patients,avoid complications as far as possible and ensure good curative effect,which is worthy of application and promotion.