早期颅骨修补术治疗颅脑外伤术后颅骨缺损的效果分析

Therapeutic effect of early cranioplasty on skull defect after craniocerebral trauma surgery

目的:分析早期颅骨修补术治疗颅脑外伤术后颅骨缺损的效果。方法:抽取2018年10月至2022年10月河南省第二人民医院收治的颅脑外伤术后颅骨缺损患者62例,按照随机数字表法将患者分为对照组和研究组,每组31例。对照组采用晚期(颅脑外伤术后3~6个月)颅骨修补术治疗,研究组采用早期(颅脑外伤术后1~3个月)颅骨修补术治疗。比较两组围术期指标(手术时间、术中出血量),比较两组手术前后双侧大脑中动脉(MCA)血流速度、神经功能[中国脑卒中临床神经功能缺损量表(CSS)评分、美国国立卫生研究院卒中量表(NIHSS)评分],比较两组并发症发生率。结果:研究组术中出血量[(314.69±28.49)ml]少于对照组[(347.48±32.96)ml],P<0.05。术后2个月,研究组缺损侧MCA血流速度大于对照组(P<0.05),CSS评分、NIHSS评分低于对照组(P<0.05),ADL评分、KPS评分高于对照组(P<0.05)。研究组并发症发生率(3.23%,1/31)低于对照组(25.81%,8/31),P<0.05。结论:早期颅骨修补术治疗颅脑外伤术后颅骨缺损的效果较好,能减少术中出血量,明显改善颅骨缺损部位MCA血流速度,恢复患者神经功能,且能降低并发症发生率。

Objective To analyze the therapeutic effect of early skull repair on skull defect after craniocerebral trauma.Methods Sixty-two patients with skull defect after craniocerebral trauma treated in the Henan Second Provincial People's Hospital of from October 2018 to October 2022 were selected,and they were divided into control group and study group according to random number table method,with 31 cases in each group.The control group received late stage(3-6 months after craniocerebral trauma surgery)cranioplasty,while the study group received early stage(1-3 months after craniocerebral trauma surgery)cranioplasty.Perioperative indexes(operation time,intraoperative blood loss)were compared between two groups;the blood flow velocity of bilateral middle cerebral arteries(MCA),neurological function assessed by Chinese Stroke Clinical Neurological Deficiency Scale(CSS)and National Institutes of Health Neurological Deficiency Scale(NIHSS)score before and after surgery were compared between two groups;the incidence of complications of the two groups were compared.Results The intraoperative blood loss in the study group was(314.69±28.49)ml,less than the(347.48±32.96)ml in the control group(P<0.05).Two months after surgery,the MCA blood flow velocity in the defected side in the study group was higher than that in the control group(P<0.05),while the CSS score and NIHSS score in the study group were lower than those in the control group(P<0.05),moreover,the ADL score and KPS score in the study group were higher than those in the control group(P<0.05).The complication rate of the study group(3.23%,1/31)was lower than that of the control group(25.81%,8/31),P<0.05.Conclusions Early cranioplasty is effective in the treatment of skull defect after craniocerebral trauma surgery.It can reduce intraoperative blood loss,improve the MCA blood flow velocity in the defected side,restore neurological function,and reduce the incidence of complications.