颅脑损伤去骨瓣减压术后超早期颅骨成形术的疗效分析

目的 探讨重型颅脑损伤去骨瓣减压术后超早期（3~6周）行颅骨成形术的临床疗效。方法 选择2012年1月至2015年10月颅脑损伤去骨瓣减压后行颅骨缺损成形术的患者75例，其中超早期（3~6周）行颅骨成形术60例（超早期组），常规（3~6个月）行颅骨成形术15例（常规组）。结果 超早期组和常规组的手术时间（124.6±57.5）min vs（142.2±45.3）min]、皮瓣游离时间（38.7±10.4）min vs （56.3±17.4）min]、术中出血量（183.6±89.4）ml vs （293.0±75.7）ml]均具有统计学差异（P<0.05）。两组术后并发症发生率无统计学差异（>P>0.05）。术后6个月，超早期组Barthel指数、MMSE评分、GOS评分均明显优于常规组（P<0.05）。>结论 颅脑损伤行去骨瓣减压术后超早期行颅骨成形术优于常规手术，能明显改善患者的预后。

Curative effect of cranioplasty ultra-early after decompressive craniectomy on patients with severe traumatic brain injury

Objective To investigate the curative effect of cranioplasty ultra-early (3~6 weeks) after decompressive craniectomy on patients with severe traumatic brain injury (sTBI). Methods Of seventy-five patients with sTBI, 60 (ultra-early group) received cranioplasty untra-early (3~6 weeks) after decompressive craniectomy and 15 (conventional group) received cranioplasty 3~6 months after decompressive craniectomy from January, 2012 to October, 2015. Results There were significant differences in the operative time (124.6±57.5) min vs (142.2±45.3) min], flap free time (38.7±10.4) min vs (56.3±17.4) min], and blood loss volume (183.6±89.4) ml vs (293.0±75.7) ml] between ultra-early group and conventional group (P<0.05). there="" was="" no="" statistical="" difference="" in="" the="" postoperative="" complication="" rate="" between="" two="" groups="" (P>0.05). Compared with conventional group, Barthel index, activities of daily living, mini-mental state examination and GOS scores of ultra-early group were significantly improved 6 months after the operation (P