去骨瓣减压术后行早期颅骨修补术治疗重型颅脑外伤患者的效果分析  

Effect Analysis of Early Cranioplasty after Decompressive Craniotomy in Patients with Severe Craniocerebral Trauma

作　　者：刘大海 LIU Dahai(Department of Craniocerebral Diseases Surgery,Lanling People’s Hospital,Linyi 277700,China)

机构地区：[1]山东省兰陵县人民医院颅脑疾病外科,山东临沂277700

出　　处：《中国伤残医学》2024年第16期74-76,85,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨去骨瓣减压术(DC)后行早期颅骨修补术(CP)在重型颅脑外伤患者中的应用效果。方法:选择2021年4月—2023年10月兰陵县人民医院收治的90例重型颅脑外伤患者为研究对象,按随机数字表法将其分为研究组与对照组,各45例。两组均采用DC治疗,对照组DC治疗后实施CP治疗,研究组DC术后实施CP治疗,两组均持续随访6个月。对比两组脑血流情况、神经功能、独立性并发症发生情况和预后情况。结果:CP术后6个月,两组大脑前、中、后动脉的血流速度均快于术前,且研究组均快于对照组,差异均有统计学意义(P<0.05)。CP术后6个月,两组卡式功能状态、格拉斯哥预后量表及用功能独立性评定量表评分均高于术前,且研究组均高于对照组,两组美国国立卫生研究院卒中量表评分均低于术前,且研究组低于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率4.44%低于对照组的17.77%,差异有统计学意义(P<0.05)。结论:DC术后行早期CP治疗重型颅脑外伤患者有助于改善其脑血流情况和神经功能,减少并发症,提高独立性,利于预后。Objective:To investigate the effect of early cranioplasty(CP)after decompressive craniotomy(DC)in patients with severe craniocerebral trauma.Methods:A total of 90 patients with severe craniocerebral trauma admitted to Lanling County People’s Hospital from April 2021 to May 2023 were selected as the study objects,and were divided into a study group and a control group according to random number table method,with 45 cases in each group.Both groups were followed up for 6 months.The cerebral blood flow,neurological function,the independence,the occurrence of complications and prognosis were compared between the two groups.Results:Six months after CP surgery,the blood flow velocity of anterior middle and posterior cerebral arterties in both groups were faster than those before surgery,and the study group were faster than the control group,the differences were statistically significant(P<0.05).Six months after CP surgery,the scores of Karnofsky Performance Scale,Glasgow Outcome Scale and Functional Independence Measure in both groups were higher than before surgery,and the study group were higher than the control group,the scores of National Institutes of Health Stroke Scale in both groups was lower than before surgery,and the study group was lower than the control group,with statistical significance(P<0.05).The complication rate was 4.44%in the study group lower than 17.77%in the control group,the difference was statistically significant(P<0.05).Conclusion:Early CP treatment of patients with severse craniocerebral trauma after DC surgery is helpful to improve cerebral blood flow and neurological function,reduce complications,improve independence,and facilitate prognosis.

关 键 词：颅脑外伤 去骨瓣减压术 颅骨修补术 脑血流 神经功能 

分 类 号：R64[医药卫生—外科学]