颅骨修补时机对去骨瓣减压术后颅骨缺损患者脑血流动力学及其认知功能的影响  

Effect of Cranioplasty Timing on Cerebral Hemodynamics and Cognitive Function in Patients with Skull Defects after Decompressive Craniectomy

作　　者：亢志强 杜宝顺[1] 程振国[1] KANG Zhi-qiang;DU Bao-shun;CHENG Zhen-guo(Department of Neurosurgery,Xinxiang Central Hospital,Xinxiang,453000,China)

机构地区：[1]新乡市中心医院神经外科,河南新乡453000

出　　处：《医学临床研究》2022年第4期507-509,513,共4页Journal of Clinical Research

基　　金：新乡市重点科技攻关计划项目(2G14016)。

摘　　要：【目的】探讨颅骨修补时机对去骨瓣减压术后颅骨缺损患者脑血流动力学及其认知功能的影响。【方法】前瞻性选择本院收治的82例去骨瓣减压术后颅骨缺损患者的临床资料,根据颅骨不同修补时机将其分为观察组(n=40)和对照组(n=42)。两组根据其认知障碍程度进一步分为轻度组、中度组和重度组,比较两组不同认知功能患者手术前后简易智能状态量表(MMSE)评分,并比较各组患者手术前后脑血流情况。【结果】术后3个月,两组认知障碍轻度、中度、重度患者ACA、MCA、PCA局部血流量均高于术前2d,且观察组高于对照组,差异有统计学意义(P<0.05);两组认知障碍轻度、中度患者MMSE评分高于术前2d,差异有统计学意义(P<0.05);观察组认知障碍轻度、中度患者MMSE评分高于对照组,差异有统计学意义(P<0.05);两组重度认知障碍患者的MMSE评分较术前无明显改善,差异无统计学意义(P>0.05)。【结论】早期颅骨修补可以明显改善颅骨缺损患者局部脑血流,从而显著促进轻中度认知障碍患者认知功能的恢复;但是对于重度认知障碍患者,早晚期颅骨修补对其认知功能的改善无明显差别。【Objective】To explore the effect of cranioplasty timing on cerebral hemodynamics and cognitive dysfunction in patients with skull defects after decompressive craniectomy.【Methods】The clinical data of 82 patients with skull defect after decompressive craniectomy in our hospital were prospectively selected,and they were divided into observation group(n=40)and control group(n=42)according to different skull repair timings.The two groups were further divided into mild group,moderate group and severe group according to the degree of cognitive impairment.The scores of the Mini-Mental State Scale(MMSE)before and after surgery were compared between the two groups of patients with different cognitive functions,and the cerebral blood flow before and after surgery in each group was compared as well.【Results】3 months after operation,the local blood flow of ACA,MCA and PCA in patients with mild,moderate and severe cognitive impairment in the two groups were all higher than those 2 days before operation,and the observation group was higher than the control group,and the difference was statistically significant(P<0.05);the MMSE scores of the patients with mild and moderate cognitive impairment in the two groups were higher than 2 days before surgery,and the difference was statistically significant(P<0.05);the MMSE scores of the patients with mild and moderate cognitive impairment in the observation group were higher than In the control group,the difference was statistically significant(P<0.05);the MMSE scores of the patients with severe cognitive impairment in the two groups were not significantly improved compared with those before operation,and the difference was not statistically significant(P>0.05).【Conclusion】Early cranioplasty can significantly improve local cerebral blood flow in the patients with skull defect,thus significantly promote the recovery of cognitive function in patients with mild to moderate cognitive impairment.However,for the patients with severe cognitive impairment,early cranioplasty and

关 键 词：颅骨/损伤 颅骨/外科学 减压颅骨切除术 血流动力学 认知 

分 类 号：R651.1[医药卫生—外科学]