早期颅骨修补术治疗颅脑外伤术后颅骨缺损的临床疗效

摘要

Objective To analyze the clinical effect of early skull repairing surgery on skull defect after craniocerebral trauma surgery. Methods 200 cases of patients with skull defect after craniocerebral trauma surgery who implemented skull repairing surgery in our hospital from March 2012 to March 2014 were randomly selected as objects. All patients were divided into control group (100 cases) and observation group (100 cases) according to different treatment method. The observation group was given early skull repairing surgery (within 3 months), the control group received advanced skull repairing surgery (after 3 months). The prognosis of two groups was evaluated by glasgow prognosis score (GOS), the KPS score and adverse reactions after two months of the surgery were observed. Results The KPS score of observation group was 82.06±13.86, higher than 72.36±13.98 of control group, with statistical difference (P<0.05). The excellent and good rate of GOS in observation group were 36.00%and 28.00%respectively, higher than 21.00%and 14.00%in control group;the incidence of severe disability and vegetative state in observation group were 34.00%and 2.00%respectively, lower than 56.00%and 9.00%in control group, all the difference was statistical (P<0.05). The complications rate of observation group was 4.00%, with infection in 2 cases and cerebral edema in 2 cases;the complications rate of control group was 12.00%, with infection in 4 cases, shunt tube obstruction in 6 cases and cerebral edema in 2 cases; the complications rate of observation group was higher than that of control group, with statistical difference (P <0.05). Conclusions Early skull repairing surgery can effectively improve the neurological function and consciousness of patients with skull defect, and also improve patients' living quality with less complications, which has significant clinical effect and deserves promotion.%目的：分析早期颅骨修补术治疗颅脑外伤术后颅骨缺损的临床疗效。方法随机选取2012年3月至2014年3月我院收治的颅脑外伤手术后针对颅骨缺损行颅骨修补术的200例患者为研究对象。按照治疗方法的不同将患者分为对照组与观察组各100例。观察组患者行早期颅骨修补术(3个月内)，对照组患者行晚期颅骨修补术(3个月后)。按G韵杂评分标准评估患者预后，并观察术后2个月患者的运P杂得分和并发症的发生情况。结果观察组运P杂评分为(82.06±13.86)分，显著高于对照组的(72.36±13.98)分，差异具有统计学意义(P<0.05)。观察组G韵杂预后优良率分别为36.00豫和28.00豫，显著高于对照组的21.00豫和14.00豫；观察组重度残疾和植物生存发生率分别为34.00豫和2.00豫，显著低于对照组的56.00豫和9.00豫；差异均具有统计学意义(P<0.05)。观察组出现2例感染，2例脑水肿，并发症发生率为4.00豫；对照组出现4例感染，6例分流管堵塞和2例脑水肿，并发症发生率为12.00豫；观察组并发症发生率显著低于对照组，差异具有统计学意义(P<0.05)。结论早期颅骨修补术可较为明显地改善颅骨缺损患者的神经功能和意识，提高患者的生存质量，并发症较少，疗效显著，值得临床推广应用。