目的 分析外伤性颅骨缺损不同修补时间窗对预后的影响。方法 回顾性分析颅脑损伤去骨瓣减压术后患者72例，按照行颅骨修补的不同时间分为超早期（4~6 周）、早期（7~8 周）、常规期（≥3个月）3组，比较术后并发症发生率、神经功能改善及生活质量的差异。结果 超早期组皮瓣下积血、积液的发生率（25%、31.25%），均高于早期组（3.84%、3.84%）及常规组（3.33%、3.33%），差异有统计学意义（P＜0.05）；超早期、早期组神经功能改善与常规组比较，差异有统计学意义（P＜0.01），生活质量评分也显著高于常规组（P＜0.05）；超早期、早期组术后精神症状改善较常规组有显著性差异(P＜0.05)，超早期与早期组之间术后精神症状的改善差异无统计学意义（P＞0.05）。结论 外伤性颅骨缺损选择早期颅骨修补可以显著降低超早期颅骨修补术后并发症，较常规时间颅骨修补明显改善神经功能障碍及精神症状，提高生活质量，临床效果满意。
Abstract
Objective To study the prognosis of patients with traumatic skull defect at distinct time points after cranioplasty. Methods Groups of severe craniocerebral trauma patients were classified as super early phase (4-6 w), early phase (7-8 w), normal phase (≥3 m) after decompress hemicraniectomy (DCH) before undergoing cranioplasty. Retrospective analysis was made to compare the difference in postoperative complications，neural function and life quality between the groups. Results The incidence of flap hematocele and flap hydrops in super early phase group was significantly higher (25%; 31.25%) than in the other groups （3.84%, 3.84%; 3.33,3.33%） (P0.05). Conclusions Early cranioplasty can significantly reduce postoperative complications, improve life quality and neural function and can produce satisfactory clinical effect.
关键词
颅脑损伤 /
外伤性颅骨缺损 /
颅骨修补 /
预后
Key words
craniocerebral trauma /
traumatic skull defect /
cranioplasty /
prognosis
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