去骨瓣减压术后患者早期行颅骨修补术治疗的临床效果分析  

Clinical analysis of early cranioplasty for patients undergoing decompressive craniectomy

作　　者：于强[1] 黄好峰 李习珍 胡海成[1] 李春[1] 张成[1] 韩超[1] 王如海 曹祥记 YU Qiang;HUANG Hao-feng;LI Xi-zhen(The No.5 People's Hospital of Fuyang City,Fuyang 236001,China)

机构地区：[1]阜阳市第五人民医院神经外科

出　　处：《中国处方药》2019年第12期122-123,共2页Journal of China Prescription Drug

摘　　要：目的探究去骨瓣减压术后患者早期行颅骨修补术治疗的临床效果。方法选取某院2014年5月~2018年7月行去骨瓣减压术后颅骨缺损患者46例,按照随机原则将患者分为观察组23例和对照组23例。对照组去骨瓣减压术后3~6个月行颅骨修补术,观察组在术后3个月内行颅骨修补术。随访1年,比较两组患者总手术时间、游离皮瓣时间和术中出血量;术前和术后半年神经功能水平;术前和术后1年的生活质量水平;术后并发生发生率。结果观察组患者手术总时间、皮瓣分离时间、术中出血量均高于观察组,差异具有统计学意义(P <0.05)。两组术前GOS评分、KPS评分、NIHSS、SF-36评分比较差异无统计学意义(P> 0.05)。术后半年观察组GOS评分、KPS评分高于对照组,术后1年两组患者NIHSS评分均下降,观察组下降较对照组更明显,SF-36评分均上升,观察组上升较对照组明显,差异具有统计学意义(P <0.05);对照组术后并发症发生率34.7%高于观察组术后并发症发病率8.7%,差异具有统计学意义(P <0.05)。结论去骨瓣减压术后患者早期行颅骨修补术可以改善神经功能和认知水平,提高生活质量,降低并发症发生率。Objective To explore the clinical effect of early cranioplasty for patients undergoing decompressive craniectomy.Methods Forty-six patients with skull defect after decompressive craniectomy were enrolled in our hospital from May 2014 to July 2018. Patients were divided into observation group(23 cases) and control group(23 cases) according to the random principle. In the control group, the skull repair was performed from March to June after decompressive craniectomy. The patients in the observation group underwent cranioplasty within 3 months after operation. After 1 year of follow-up, the total operation time, free flap time and intraoperative blood loss were compared between the two groups;the neurological function level before and after the operation;the quality of life before and 1 year after surgery;the incidence of postoperative complications.Results The total operation time, flap separation time and intraoperative blood loss were higher in the observation group than in the observation group(P < 0.05). There were no significant differences in preoperative GOS score, KPS score, NIHSS and SF-36 scores between the two groups(P > 0.05). The GOS score and KPS score of the observation group were higher than the control group in the half year after operation. The NIHSS scores of the two groups decreased in the 1 year after operation. The decrease of the observation group was more obvious than that of the control group, and the SF-36 score increased. The increase of the observation group was significantly higher than that of the control group(P < 0.05). The incidence of complications was 34.7% higher than that of the observation group(8.7%). Conclusion Early cranioplasty after decompressive craniectomy can improve neurological function and cognitive level, improve quality of life, and reduce the incidence of complications, which is worthy of clinical promotion.

关 键 词：去骨瓣减压术 颅骨修补 早期 预后 

分 类 号：R65[医药卫生—外科学]