早期颅骨修补术治疗脑外伤合并颅骨缺损患者的疗效

Efficacy of early cranioplasty in the treatment of brain injury complicated with skull defect

目的 分析脑外伤合并颅骨缺损患者行早期颅骨修补术的临床疗效及对Barthel指数(BI)评分的影响。方法 选取2020-03—2022-03广西壮族自治区江滨医院治疗的脑外伤恢复期合并颅骨缺损患者98例,对照组患者进行晚期颅骨修补术,研究组患者进行早期颅骨修补术。结果 研究组不良反应总发生率(6.12%)比对照组(24.48%)低(P<0.05)。研究组治疗后NIHSS评分[(11.13±2.94)分]比对照组[(15.32±2.63)分]低,MMSE评分[(26.24±2.01)分]、BI评分[(84.16±6.35)分]比对照组[(20.02±2.39)分、(71.03±7.54)分]高(分别为t=17.321,16.527,16.058,P<0.05)。研究组社会功能[(83.81±3.65)分]、躯体功能[(85.56±2.74)分]、物质生活[(83.81±3.65)分]、心理功能评分[(85.24±3.23)分]均比对照组[(73.51±3.83)分、(71.41±3.55)分、(73.51±3.73)分、(73.80±3.41)分]高(分别为t=12.036,12.115,12.413,12.334,P<0.05)。研究组治疗后KPS评分[(83.15±7.23)分]、GOS评分[(4.12±0.36)分]均比对照组[(72.13±6.27)分、(3.54±0.40)分]高(分别为t=16.038,16.113,P<0.05)。结论 早期颅骨修补术在脑外伤合并颅骨缺损患者中效果理想,可以有效改善患者的认知、神经功能,降低不良反应发生率的同时改善患者预后,提高其日常生活能力和生活质量。

Objective To analyze the clinical effect of early cranioplasty and its effect on Barthel index(BI)score in patients with brain injury combined with skull defect.Methods A total of 98 patients with brain trauma combined with skull defect who were treated in Jiangbin Hospital,Guangxi Zhuang Autonomous Region from March 2020 to March 2022 were selected.Patients in the control group received late cranioplasty,and pa-tients in the study group received early cranioplasty.Results The total incidence of adverse reactions in the study group(6.12%)was lower than that in the control group(24.48%)(P<0.05).The NIHSS score of the study group((11.13±2.94)points)was lower than that of the control group((15.32±2.63)points),MMSE scores((26.24±2.01)points)and BI scores((84.16±6.35)points)were higher than those in control group((20.02±2.39)points,(71.03±7.54)points)(t=17.321,16.527,16.058,respectively,P<0.05).The social function score((83.81±3.65)points),physical function score((85.56±2.74)points),material life score((83.81±3.65)points)and psychological function score((85.24±3.23)points)of the study group were all higher than those of the con-trol group((73.51±3.83)points,(71.41±3.55)points,(73.51±3.73)points),and((73.80±3.41)points)(t=12.036,12.115,12.413,12.334,respectively,P<0.05).KPS scores((83.15±7.23)points)and GOS scores((4.12±0.36)points)in the study group were higher than those in the control group((72.13±6.27)points and(3.54±0.40)points)(t=16.038,16.113,respectively,P<0.05).Conclusion Early cranioplasty has an ideal effect in pa-tients with brain injury combined with skull defect,which can effectively improve the cognitive and neurological function of patients,reduce the incidence of adverse reactions,improve the prognosis of patients,and improve their daily life ability and quality of life.