早期颅骨修补术在颅脑外伤术后颅骨缺损患者中的应用

Application of Early Cranioplasty in Patients with Skull Defect after Craniocerebral Trauma Surgery

目的:探讨早期颅骨修补术在颅脑外伤术后颅骨缺损患者中的应用。方法:选取2019年1月—2023年1月常熟市中医院神经外科收治的80例颅脑外伤术后颅骨缺损患者作为研究对象。根据随机数表法将其分为对照组和观察组,各40例。两组均给予颅骨修补术。对照组在颅脑外伤术后4~6个月实施颅骨修补术,观察组在颅脑外伤术后1~3个月实施颅骨修补术。比较两组术前、术后1个月认知功能、神经功能、日常生活能力、颅脑外伤严重程度、生活质量及并发症。结果:术后1个月,两组美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分低于术前,简易智力状态检查量表(mini-mental state examination,MMSE)评分、Barthel指数(BI)评分均高于术前,观察组NIHSS评分低于对照组,MMSE评分、BI评分均高于对照组,差异有统计学意义(P<0.05)。术后1个月,两组认知功能、运动功能、睁眼反应、进食、如厕、语言表达能力、整体功能、受雇能力评分均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。观察组术后1个月的社会功能、躯体功能、物质生活、心理功能评分均高于对照组,差异有统计学意义(P<0.05)。结论:早期颅骨修补术能够有效改善颅脑外伤术后颅骨缺损患者的认知功能和神经功能,降低患者并发症发生率,提高患者的日常生活能力和生活质量。

Objective:To explore the application of early cranioplasty in patients with skull defect after craniocerebral trauma surgery.Method:A total of 80 patients with with skull defect after craniocerebral trauma surgery admitted to the Neurosurgery Department of Changshu Traditional Chinese Medicine Hospital from January 2019 to January 2023 were selected as the study objects.They were divided into control group and observation group by random number table method,40 cases in each group.Both groups were given cranioplasty.The control group underwent cranioplasty 4 to 6 months after craniocerebral trauma surgery,and the observation group underwent cranioplasty 1 to 3 months after craniocerebral trauma surgery.Cognitive function,neurological function,daily living ability,craniocerebral injury severity,quality of life before and 1 month after surgery and complications were compared between the two groups.Result:At 1 month after surgery,the National Institute of Health stroke scale(NIHSS)score of the two groups were lower than those before surgery,and the mini-mental state examination(MMSE)score and Barthel index(BI)score were higher than those before surgery,NIHSS score in observation group was lower than that in control group,MMSE score and BI score were higher than those in control group,the differences were statistically significant(P<0.05).At 1 month after surgery,the scores of cognitive function,motor function,eye opening response,eating,toilet use,language expression ability,overall function and employability in both groups were lower than before surgery,and the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).The scores of social function,physical function,material life and psychological function in the observation group were higher than those in the control group at 1 month after surgery,and the differences were statistically significant(P<0.05).Conclusion:Early cranioplasty can effectively improve the cognitive function and neurological function of patients with skull defect after craniocerebral trauma surgery,reduce the incidence of complications of patients,and improve the daily living ability and quality of life of patients.