早期颅骨修补术对脑外伤患者临床疗效及不良反应的影响

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摘要目的探讨早期颅骨修补术对脑外伤患者临床疗效及不良反应的影响。方法选取2020-03至2022-03于医院治疗的脑外伤恢复期合并颅骨缺损患者98例,根据去骨瓣减压术后颅骨修补手术时机分为两组,对照组术后6个月后行颅骨修补术,研究组术后3个月内行颅骨修补术,观察对比两组患者术后的不良反应发生率、认知功能、神经功能、日常生活能力、生活质量改善程度。结果研究组不良反应发生率(6.12%)低于对照组(24.48%)(P＜0.05);研究组术后NIHSS评分(11.20±2.65)低于对照组(15.41±2.62),MMSE评分(27.02±1.77)高于对照组(20.33±2.46)),BI评分(84.08±6.28)高于对照组(71.61±7.42),差异均有统计学意义(P＜0.05)。研究组术后KPS、GOS评分均高于对照组(P＜0.05)。结论早期颅骨修补术能有效改善患者的认知、神经功能,减少不良反应,改善患者预后。

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	王健
	刘爱贤
	张文毅

关键词 ：脑外伤, 早期颅骨修补术, 临床疗效, 不良反应

Abstract：Objective To analyze the effect of early cranioplasty on clinical efficacy and adverse reactions in patients with traumatic brain injury.Methods Ninety-eight patients with traumatic brain injury complicated with skull defect treated in Beijing Rehabilitation Hospital of Capital Medical University from March 2020 to March 2022 were divided into two groups according to the timing of cranioplasty after decompressive craniectomy. Cranioplasty was performed 6 months after operation in the control group and within 3 months after operation in the study group. The incidence of postoperative adverse reactions, cognitive function, neurological function, activities of daily living and quality of life were observed and compared between the two groups.Results The total incidence of adverse reactions in the study group (6.12%) was lower than that in the control group (24.48%). After treatment, the NIHSS score of the study group was lower than that of the control group (15.41±2.62), and the MMSE score of the study group was higher than that of the control group. BI score (84.08±6.28) was higher than that of the control group (71.61±7.42). The scores of social function, physical function, material life and psychological function in the study group were higher than those in the control group, and the scores of KPS and GOS in the study group were higher than those in the control group after treatment.Conclusions Early cranioplasty can effectively improve the cognitive and neurological function of patients, reduce the adverse reactions and improve the prognosis of patients.

Key words： traumatic brain injury early cranioplasty clinical efficacy adverse reactions

收稿日期: 2023-02-20

ZTFLH:

R651.1

通讯作者: 刘爱贤,E-mail:lax721@163.com

作者简介: 王健,硕士,医师。

引用本文:

王健, 刘爱贤, 张文毅. 早期颅骨修补术对脑外伤患者临床疗效及不良反应的影响[J]. 武警医学, 2023, 34(5): 373-376. WANG Jian, LIU Aixian, ZHANG Wenyi. Effect of early cranioplasty on clinical efficacy and adverse reactions in patients with traumatic brain injury. Med. J. Chin. Peop. Armed Poli. Forc., 2023, 34(5): 373-376.

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http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2023/V34/I5/373

[1]	杨新平,刘谊,陈鹏飞. 脑外伤术后不同时期行颅骨缺损修补术的效果及安全性对比观察[J]. 中华保健医学杂志,2020,22(1):57-60.
[2]	冯毅,杨理坤,王玉海. 去骨瓣减压术后脑脊液动力学障碍[J]. 中华神经创伤外科电子杂志,2017,3(3):179-184.
[3]	王康宁. 颅骨修补术对创伤性脑损伤患者脑血流灌注及神经认知功能的影响研究[D]. 海口:海南医学院,2022.
[4]	Tora M S , Malcolm J G , Mahmooth M Z , et al. Complication Rates in Early Versus Late Cranioplasty—A 14-Year Single-Center Case Series[J]. Operative Neurosurgery, 2021, 20(4):389-396.
[5]	陈真,张林林. 脑外伤患者行早期颅骨修补手术的临床疗效及对患者NIHSS与MMSE评分的影响[J]. 贵州医药,2022,46(2):254-255.
[6]	张金博. 早期颅骨修补术治疗脑外伤的效果及对患者神经功能和日常生活能力的影响分析[J]. 中国现代药物应用,2021,15(7):43-45.
[7]	张弹,李显伟,潘丽,等. 探讨人性化护理对脑外伤患者疗效以及生活质量的影响[J]. 糖尿病天地,2021,18(1):290.
[8]	张雷. 脑外伤术后不同时期行颅骨缺损修补术的效果及安全性对比观察[J]. 智慧健康,2022,8(7):29-31.
[9]	曹栓柱,吕明亮,何建昌,等.重型颅脑损伤后行超早期修复颅骨缺损对患者预后的影响临床研究[J].中国临床神经科学,2021,29(4):387-405.
[10]	欧阳龙强,夏文燕,杨少春,等.去骨瓣减压术后早期颅骨修补术对颅脑创伤患者神经功能和认知功能的影响[J].中国现代神经疾病杂志,2020,20(7):620-624.
[11]	张尚明,李松远,陈宏颉,等.侧脑室-腹腔分流术后或同期行颅骨修补术继发硬膜外积液的危险因素和疗效分析[J].中华神经外科杂志,2020,36(11):1165-1169.
[12]	高玉华,赵有发,魏民,等.脑室-腹腔分流术联合同期颅骨修补术治疗脑创伤合并脑积水的临床疗效[J].医学综述 2020,26(9):1869-1873.
[13]	申向竹,张山,韩亚非,等.联合手术对脑外伤患者的临床效果及术后硬膜下积液的危险因素分析[J].实用临床医药杂志,2021,25(11):22-25.
[14]	张建波,杨平来,曾武,等.同期与分期行颅骨修补术及脑室-腹腔分流术治疗创伤性脑损伤脑积水的疗效比较[J].实用临床医药杂志,2021,25(19):39-48.
[15]	Hoek A E, Joosten M, Dippel D,et al. Effect of video discharge instructions for patients with mild traumatic brain injury in the emergency department: a randomized controlled trial[J]. Annals of Emergency Medicine,2021,77(3):327-337.
[16]	Katayama M. A multilayered dural repair technique using duragen for early cranioplasty following decompressive craniotomy[J]. Surgeries, 2021, 2(4):371-377.
[17]	Moll A,Lara M,Pomar J,et al.Effects of dexamethasone in traumatic brain injury patients with pericontusional vasogenic edema: a prospective-observational DTI-MRI study[J]. Medicine,2020,99(43):e22879.
[18]	Shankar J,Green R, Virani K,et al. Admission perfusion CT for classifying early in-hospital mortality of patients with severe traumatic brain injury: a pilot study[J]. Am J Roentgenol,2020,214(4):1-5.
[19]	Cola M. Can cranioplasty be considered a tool to improve cognitive recovery following traumatic brain injury? a 5-years retrospective study[J]. J Clin Med, 2021, 10(22),5437.
[20]	Ishida N,Miyazu T,Sugiyama T,et al. The effect of early trough level of infliximab on subsequent disease course in patients with Crohn disease: a prospective cohort study[J].Medicine,2020,99(29):e21226.