早期颅骨成形术在重型颅脑外伤患者骨瓣减压后的应用价值分析  

Application value analysis of early cranioplasty in patients with severe brain injury after decompression flap

作　　者：郝大江[1] 

机构地区：[1]山西省大同市第三人民医院神经外科,037008

出　　处：《中国实用医刊》2016年第9期46-47,共2页Chinese Journal of Practical Medicine

摘　　要：目的分析早期颅骨成形术在重型颅脑外伤患者骨瓣减压后的应用价值。方法以2012年3月至2013年12月收治的60例重型颅脑外伤患者为研究对象，均行骨瓣减压术，其中术后早期颅骨成形术40例，为早期组，术后3—6个月行颅骨成形术20例，为晚期组，术后随访1年，比较两组治疗前后神经功能缺损（NIHSS）评分、日常生活能力（Barthel）指数、格拉斯哥预后（GOS）评分、格拉斯哥昏迷（GCS）评分及并发症情况。结果早期组术后4周NIHSS评分、Barthel指数评分分别为（14．3±3．2）分、（79．0±31．4）分，与晚期组的（19．4±4．8）分、（61．6±24．0）分比较差异有统计学意义（P〈0．05）。早期组并发症发生率为10．0％，与晚期组的50．0％比较差异有统计学意义（P〈0．01）。另外，两组术后1年GOS及GCS评分比较差异有统计学意义（P〈0．05）。结论骨瓣减压后早期颅骨成形术能明显减少并发症发生，促进神经功能恢复，改善患者预后，值得临床推广。Objective To analyze the application value of early skull flap after angioplasty in patients with severe brain trauma decompression. Methods Sixty cases of severe traumatic brain injury in the third people＇ s hospital of Datong from March 2012 to December 2013 were treated in this study underwent decompressive eraniectomy, among which 40 cases underwent early postoperative cranioplasty were early group, 20 cases underwent angioplasty postoperative 3 to 6 months were the late group. All the cases were followed up for one year, NIHSS（ neurological deficit） score, Barthel（ activities of daily living） index, GOS（ Glasgow outcome） score, GCS（ Glasgow coma Scale） score and complications of the two groups were compared before and after treatment. Results Four weeks after the early group NIHSS score, Barthel index score were （ 14. 3 ±3.2） points, （79. 0 ± 31.4 ） points, late stage group were （ 19.4 ± 4. 8 ） points, （ 61.6 ± 24. 0 ） points, the differences were significant （ P 〈 0.05 ）. Early complication rate of the early group was 10. 0% and 50. 0% in the late group, and the difference was significant（ P 〈0. 01 ）. In addition, postoperative GOS and GCS scores after 1 year was sig- nificant（ P 〈 0. 05 ）. Conclusions After hemicraniectomy, early cranioplasty can significantly reduce complications and promote recovery of neurological function and improve patient outcomes, so it is worthy of being promotion.

关 键 词：早期颅骨成形术 重型颅脑外伤 骨瓣减压术 效果 

分 类 号：R651.11[医药卫生—外科学]