| 摘要 |
【摘要】目的探讨超早期颅骨修补对颅脑损伤术后颅骨缺损患者认知功能及脑血管反应性的影响。方法连续纳入2013年8月—2015年9月我院收治的100例颅脑损伤术后颅骨缺损患者为研究对象，依据患者颅脑损伤术后颅骨修补时间均分为2组，常规组（颅脑损伤术后3—6个月）50例，超早期组（颅脑损伤后4—6周）50例，观察术前、术后2组神经功能缺损[中国卒中患者神经混能缺损评分（China Stroke Scale，CSS）]、认知功能[采用联合型瑞文智力测验(combined ravens test，CRT)评分评价]、脑血管反应性[采用屏气试验评价（cerebrovascular reactivity, CVR）评分评价]、心理状况[焦虑自评量表（Self-RatingAnxietyScale,SAS）、抑郁自评量表（Self-Rating Depression Scale,SDS）]、术后并发症发生率，并随访术后1年生活质量[格拉斯哥预后评分（Glasgow outcome scale，GOS）和远期卡氏功能状态（Karnofskyperformance status，KPS）]评分评价]。结果术前2组CSS、CRT、BHI、SAS、SDS、GOS、KPS评分相较无明显差异（P＞0.05）；术后2组CSS、SAS、SDS较术前明显降低，CRT、BHI、GOS、KPS评分较术前显著升高，且术后超早期组CSS、SAS、SDS降低及BHI、GOS、KPS评分升高均较常规组明显，超早期组术后并发症总发生率4.00%较常规组18.00%明显低，有统计学意义（P＜0.05）。结论 超早期颅骨修补可明显改善患者神经功能缺损及焦虑抑郁状态，提高颅脑损伤术后颅骨缺损患者认知功能、脑血管反应性及预后生活质量，并明显降低患者术后并发症发生率，有临床推广应用价值。
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| Abstract |
【摘要】目的探讨超早期颅骨修补对颅脑损伤术后颅骨缺损患者认知功能及脑血管反应性的影响。方法连续纳入2013年8月—2015年9月我院收治的100例颅脑损伤术后颅骨缺损患者为研究对象，依据患者颅脑损伤术后颅骨修补时间均分为2组，常规组（颅脑损伤术后3—6个月）50例，超早期组（颅脑损伤后4—6周）50例，观察术前、术后2组神经功能缺损[中国卒中患者神经混能缺损评分（China Stroke Scale，CSS）]、认知功能[采用联合型瑞文智力测验(combined ravens test，CRT)评分评价]、脑血管反应性[采用屏气试验评价（cerebrovascular reactivity, CVR）评分评价]、心理状况[焦虑自评量表（Self-RatingAnxietyScale,SAS）、抑郁自评量表（Self-Rating Depression Scale,SDS）]、术后并发症发生率，并随访术后1年生活质量[格拉斯哥预后评分（Glasgow outcome scale，GOS）和远期卡氏功能状态（Karnofskyperformance status，KPS）]评分评价]。结果术前2组CSS、CRT、BHI、SAS、SDS、GOS、KPS评分相较无明显差异（P＞0.05）；术后2组CSS、SAS、SDS较术前明显降低，CRT、BHI、GOS、KPS评分较术前显著升高，且术后超早期组CSS、SAS、SDS降低及BHI、GOS、KPS评分升高均较常规组明显，超早期组术后并发症总发生率4.00%较常规组18.00%明显低，有统计学意义（P＜0.05）。结论 超早期颅骨修补可明显改善患者神经功能缺损及焦虑抑郁状态，提高颅脑损伤术后颅骨缺损患者认知功能、脑血管反应性及预后生活质量，并明显降低患者术后并发症发生率，有临床推广应用价值。【关键词】颅脑损伤；颅骨缺损；超早期颅骨修补Effect of ultra-earlyskull repair on the cognitive function and cerebrovascular reactivity in patients with skull defects after craniocerebral injury operation，Jia Yaohui, Chen Huimin, Dai Yongqing，Wang Zhiguo, Bao Zhijun[Abstract] Objective To investigate the effect of ultra-early skull repair on the cognitive function and cerebrovascular reactivity in patients with skull defects after craniocerebral injury operation.MethodsFrom August 2013 to September 2015, 100 patients with skull defects after craniocerebral injury operation in our hospital were enrolled in the study. According to the time of skull repairafter craniocerebral injury operation, the patients were divided into the routine group (3-6 months after the operation, 50 cases) and the ultra-early group (4-6 weeks after the operation). The neurological impairment [evaluated byChina Stroke Scale (CSS)], cognitive function [evaluated byCombined Ravens test (CRT)], cerebrovascular reactivity [evaluated by breath holding test (BHT)], psychological status [evaluated by Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS)] before and after operation, the incidence of postoperative complications, quality of life [Glasgow outcome scale (GOS)] and long-termKarnofskyperformance scale (KPS) scoresin 1 year of follow-up were observed.ResultsThere were no significant differences in scores of CSS, CRT, BHI, SAS, SDS, GOS and KPS between the two groups (P> 0.05). After operation, scores of CSS, SAS and SDS in the two groups were significantly lower while scores of CRT, BHI, GOS and KPS were significantly higher than those before operation, and the changes in the ultra-early group were more significant than those in the routine group. The the overall incidence of complications in the ultra-early group (4.00%) was significantly lower than that in the routine group (18.00%) (P< 0.05).ConclusionUltra-early skull repaircan effectively relieve neurological impairment, anxiety and depression, improve the cognitive function, cerebral vascular reactivity, the prognosis and quality of life of patients with skull defects after craniocerebral injury operation, and significantly reduce the incidence of postoperative complications.
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