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中华神经创伤外科电子杂志 ›› 2018, Vol. 04 ›› Issue (02) : 77 -81. doi: 10.3877/cma.j.issn.2095-9141.2018.02.004

所属专题: 文献

临床研究

标准大骨瓣减压术后不同时期行颅骨修补术的疗效及并发症观察
王坤1,(), 李冰1, 赵鹏1, 樊永帅1, 臧家蒙1, 张少虎1, 王东起1   
  1. 1. 266400 青岛,西海岸新区人民医院神经外科
  • 收稿日期:2017-11-23 出版日期:2018-04-15
  • 通信作者: 王坤
  • 基金资助:
    青岛市医药卫生优秀青年人才培养计划(青卫科教字[2017]9号)

Curative effect and complication of cranioplasty at different periods after standard bone flap decompression

Kun Wang1,(), Bing Li1, Peng Zhao1, Yongshuai Fan1, Jiameng Zang1, Shaohu Zhang1, Dongqi Wang1   

  1. 1. Department of Neurosurgery, People’s Hospital of the West Coast New Area, Qingdao 266400, China
  • Received:2017-11-23 Published:2018-04-15
  • Corresponding author: Kun Wang
  • About author:
    Corresponding author: Wang Kun, Email:
引用本文:

王坤, 李冰, 赵鹏, 樊永帅, 臧家蒙, 张少虎, 王东起. 标准大骨瓣减压术后不同时期行颅骨修补术的疗效及并发症观察[J/OL]. 中华神经创伤外科电子杂志, 2018, 04(02): 77-81.

Kun Wang, Bing Li, Peng Zhao, Yongshuai Fan, Jiameng Zang, Shaohu Zhang, Dongqi Wang. Curative effect and complication of cranioplasty at different periods after standard bone flap decompression[J/OL]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2018, 04(02): 77-81.

目的

探讨基层医院中重型颅脑损伤(sTBI)标准去大骨瓣减压术后患者不同时期行颅骨修补的疗效及并发症的影响。

方法

选取青岛市西海岸新区人民医院神经外科自2012年1月至2017年6月收治的94例标准去大骨瓣减压术后行颅骨修补患者的临床资料进行分析,按去骨瓣术后修补时间的不同,将其分为修补早期(去骨瓣术后1~3个月)组53例和晚期(去骨瓣术后3~6个月)组41例;比较2组患者颅骨修补术前及术后1年并发症发生率、神经及认知功能恢复和生存质量情况。

结果

早期组1年后并发症发生率较晚期组明显降低,差异具有统计学意义(χ2=5.502,P<0.05);早期组和晚期组在颅骨修补术前GOS评分和Karnofsky功能状态(KPS)评分相比,差异无统计学意义(P>0.05),在颅骨修补术后1年,早期组患者的GOS、KPS评分提高明显优于晚期组,差异有统计学意义(P<0.05);早期组和晚期组颅骨修补术前及术后1年的中国脑卒中患者临床神经功能缺损程度评分量表(CSS)、简易智能精神状态量表(MMSE)评分比较,2组患者术后评分均高于术前,并且术后1年早期组CSS和MMSE评分与晚期组相比,差异均有统计学意义(P<0.05)。

结论

标准去大骨瓣减压术后的sTBI患者,早期(1~3个月)颅骨修补明显减少远期并发症发生,能够显著促进神经功能和认知功能的恢复,提高患者远期生活质量。

Objective

To explore the clinical effect of different terms cranioplasty following large decompressive craniectomy in the treatment of severe traumatic brain injury (sTBI).

Methods

Retrospective analysis of clinical data of 94 patients with decompressive craniectomy, admitted to our hospitals from January 2012 to June 2017, was performed; these patients were divided into early treatment group (given treatment within 1-3 months, n=53), and late treatment group (given treatment 3-6 months, n=41); the differences of complications and survival quality between the two groups were respectively observed.

Results

After 1 year of cranioplasty, the complications of early treatment group had a higher rate than the late treatment group (χ2=5.502, P<0.05). There is no significant difference of GOS and KPS grade between the two groups before cranioplasty, but 1 year later after cranioplasty, early treatment group had a higher grade of GOS and KPS than the late treatment group (P<0.05). Furthermore, compared of CSS and MMSE between the two different treatment groups, there was significant difference between the postoperative score and preperative (P<0.05). Meantime, the CSS and MMSE of early treatment group got significantly different scores than the late treatment group (P<0.05).

Conclusion

Early cranioplasty following decompressive craniectomy helps improving the prognosis, reducing complications, promoting recovery and the quality of life.

表1 2组患者颅骨缺损修补术后1年并发症发生率的比较
表2 2组患者颅骨缺损修补术前术后GOS和Karnofsky功能状态评分的比较(±s
表3 2组患者颅骨缺损修补术前术后CSS和MMSE评分情况(±s
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