早期颅骨修补术治疗脑外伤合并颅骨缺损的临床效果  

Clinical effect of early cranial repair in treatment of brain injury complicated with skull defect

作　　者：焦云琦 JIAO Yun-qi(No.1 Department of Neurosurgery,Zhumadian Central Hospital,Zhumadian,Henan 463000,China)

机构地区：[1]驻马店市中心医院神经外一科,河南驻马店463000

出　　处：《医药论坛杂志》2024年第2期135-139,共5页Journal of Medical Forum

摘　　要：目的探讨脑外伤合并颅骨缺损行早期颅骨修补术的临床效果及美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、运动功能评估量表(Fugl-Meyer Assessment,Fugl-Meyer)评分、日常生活活动能力量表(Barthel指数)水平研究。方法选取2020年4月至2022年6月驻马店市中心医院收治的64例脑外伤恢复期合并颅骨缺损患者,均行去骨瓣减压术后颅骨修补术,按手术时间不同,将3个月内行颅骨修补术的32例作为研究组,将3至6个月后行颅骨修补术的32例作为对照组,比较两组治疗效果及NIHSS、Fugl-Meyer评分、Barthel指数水平、炎症因子C-反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)和白细胞计数(white blood cell,WBC)。结果研究组患者治疗总有效率(93.75%)高于对照组(75.00%),预后情况优于对照组,NIHSS评分[(9.81±2.20)分]低于对照组,Barthel指数[(74.52±8.23)分]、Fugl-Meyer评分[(74.68±8.84)分]高于对照组,CRP[(5.61±0.45)mg/L]、PCT[(1.22±0.10)μg/L]、WBC[(4.21±0.41)×10^(9)/L]水平低于对照组,术后并发症发生率(6.25%)低于对照组(28.13%),组间比较差异有统计学意义(P<0.05)。结论对脑外伤合并颅骨缺损患者应用早期颅骨修补术治疗可取得很好的疗效,减少各类并发症的发生,此治疗方案值得借鉴推广。Objective To investigate the clinical effect of early cranioplasty for brain injury combined with skull defect and the National Institute of Health stroke scale(NIHSS)score,Fugl-Meyer Assessment(Fugl-Meyer)score and Barthel index level study.Methods A total of 64 patients with skull defect during the recovery period of brain injury treated in our hospital from April 2020 to June 2022 were selected,all of whom underwent cranioplasty after decompress⁃or craniotomy.According to the different operation time,32 patients who underwent cranioplasty within 3 months were selected as the study group,and 32 patients who underwent cranioplasty after 3 to 6 months were selected as the control group.NIHSS,Fugl-Meyer score,Barthel index level,inflammatory factor C-reactive protein(CRP),procalcitonin(procalcitonin)were compared between the two groups.PCT and White Blood Cell(WBC).Results The total effec⁃tive rate of the study group(93.75%)was higher than that of the control group(75.00%),the prognosis was better than that of the control group,and the NIHSS score[(9.81±2.20)score]was lower than that of the control group.Barthel index[(74.52±8.23)points]and Fugl-Meyer score[(74.68±8.84)points]were higher than those of the control group.The levels of C-reactive protein(CRP)[(5.61±0.45)mg/L],procalcitonin(PCT)[(1.22±0.10)μg/L]and white blood cell count(WBC)[(4.21±0.41)×10^(9)/L]were lower than those of control group.The incidence of postoperative complications(6.25%)was lower than that of the control group(28.13%),and the difference was statistically significant(P<0.05).Conclusion Early cranial repair for patients with brain injury com⁃plicated with skull defect can achieve a good effect,reduce the incidence of various complications,this treatment plan is worthy of reference and promotion.

关 键 词：脑外伤 早期颅骨修补术 去骨瓣减压术 美国国立卫生研究院卒中量表评分 日常生活活动能力量表指数 

分 类 号：R651.1[医药卫生—外科学]