Clinical study on different period cranioplasty after decompressive craniectomy in patients with craniocerebral injury
10.3760/cma.j.issn.1673-4904.2020.01.011
- VernacularTitle: 颅脑损伤去骨瓣减压术后不同时期行颅骨修补的临床研究
- Author:
Yingjun FAN
1
;
Qiongfen WANG
2
;
Shuchuan MIAO
1
;
Haibo LIU
1
;
Enren WANG
1
Author Information
1. Department of Neurosurgery, the First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, China
2. Department of Rehabilitative Medicine, the First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, China
- Publication Type:Journal Article
- Keywords:
Craniocerebral trauma;
Decompressive craniectomy;
Postoperative complications;
Retrospective studies;
Cranioplasty
- From:
Chinese Journal of Postgraduates of Medicine
2020;43(1):45-49
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effects and complications of different period cranioplasty after decompressive craniectomy in patients with craniocerebral injury.
Methods:The clinical data of 96 craniocerebral injury patients who had underwent decompressive craniectomy in the First Affiliated Hospital of Chengdu Medical College from January 2014 to January 2018 were retrospectively analyzed. According to the different time of cranioplasty, the patients were divided into early group and routine group. In the early group, 50 patients received cranioplasty between 1.5 to 3.0 months after decompressive craniectomy; while in the conventional group, 46 patients received cranioplasty between 3.1 to 6.0 months after decompressive craniectomy. The complications after cranioplasty were observed in 2 groups, and Glasgow outcome score (GOS) and Karnofsky performance score (KPS) before cranioplasty and 3, 6 and 12 months after cranioplasty were recorded.
Results:There were no statistical difference in delayed wound healing, subcutaneous hydrops, incision infection, hydrocephalus, intracranial hemorrhage and total incidence of complications between 2 groups (P>0.05). However, the incidence of postoperative epilepsy in early group was significantly lower than that in routine group: 0 vs. 8.70% (4/46), and there was statistical difference (P<0.05). There were no statistical differences in GOS and KPS before cranioplasty between 2 groups (P>0.05); the GOS and KPS 3, 6 and 12 months after cranioplasty in early group were significantly higher than those in routine group, GOS: (3.58 ± 0.64) scores vs. (3.20 ± 0.74) scores, (3.90 ± 0.58) scores vs. (3.61 ± 0.61) scores and (4.22 ± 0.55) scores vs. (3.98 ± 0.45) scores; KPS: (56.20 ± 8.55) scores vs. (52.17 ± 7.86) scores, (68.40 ± 9.12) scores vs. (63.91 ± 10.22) scores and (75.20 ± 9.31) scores vs. (70.43 ± 10.53) scores, and there were statistical differences (P<0.01 or <0.05).
Conclusions:Early cranioplasty after decompressive craniectomy in patients with craniocerebral injury can not only reduce the incidence of postoperative epilepsy, but also be more conducive to the recovery of postoperative neurological function and improve the prognosis of patients.
