超早期颅骨修补对颅脑损伤术后颅骨缺损患者认知功能及脑血管反应性的影响  

Effect of ultra-early skull repair on the cognitive function and cerebrovascular reactivity in patients with skull defects after craniocerebral injury operation

作　　者：贾耀辉[1] 陈慧敏[1] 代永庆 王治国[1] 包志军[1] 

机构地区：[1]陕西省汉中市西安交通大学附属3201医院,汉中723000

出　　处：《国际精神病学杂志》2017年第3期516-518,535,共4页Journal Of International Psychiatry

摘　　要：目的探讨超早期颅骨修补对颅脑损伤术后颅骨缺损患者认知功能及脑血管反应性的影响。方法以2013年8月~2015年9月我院收治的100例颅脑损伤术后颅骨缺损患者为研究对象,依据患者颅脑损伤术后颅骨修补时间均分为2组,常规组(颅脑损伤术后3~6个月)、超早期组(颅脑损伤后4~6周)各50例,观察术前、术后2组认知功能[联合型瑞文智力测验(combined raven's test,CRT)评分]、脑血管反应性[屏气试验评价(cerebrovascular reactivity,CVR)评分]、术后1年生活质量[格拉斯哥预后评分(Glasgow outcome scale,GOS)和远期卡氏功能状态(Karnofskyperformance status,KPS)评分]。结果术前2组CRT评分、总BHI、GOS、KPS评分相较无明显差异(P>0.05);术后2组CRT评分、总BHI、GOS、KPS评分较术前明显升高,且术后超早期组各项评分变化较常规组明显(P<0.05)。结论超早期颅骨修补可有效提高颅脑损伤术后颅骨缺损患者认知功能、脑血管反应性及预后生活质量,有临床推广应用价值。Objective To investigate the effect of ultra-early skull repair on the cognilive function and eerebrovascular reactivity in patients with skull defects after eraniocerebral injury operation. Methods From August 2013 to September 2015, 100 patients with skull defects after cranioeerebral injury operation in our hospital were ineluded in the study. According to the time of skull repair after craniocerebral injury operation, the patients were divided into the routine group （ 3-6 months after the operation, 50 eases ） and the ultra-early group （4-6 weeks after the operation ） . The cognitive function and cerebrovascular were evaluated by Combined Raven＇s test （ CRT ） and breath holding test （BHT） in different time points. The Glasgow outcome scale （ GOS ） and long-term Karnofsky performance scale （ KPS ） were evaluated after I year of follow-up. Results There were no significant differences in CRT secures, total scores of BHI, GOS and KPS between the two groups （ P〉 0.05 ） before operation. After operation, CRT scores, total BHI, GOS and KPS scores increased significantly, and the changes were more significant in the ultra-early group than those in the routine group （P〈 0.05 ） . Conclusion Ultra-early skull repair can effectively increase the cognitive function, cerebral vascular reactivity, and improve the prognosis and quality of life of patients with skull defects after eraniocerebral injury operation.

关 键 词：颅脑损伤 颅骨缺损 超早期颅骨修补 

分 类 号：R749.1[医药卫生—神经病学与精神病学]