CAJ | 학술논문

目的分析颅脑创伤后去骨瓣减压术后早期颅骨修补对患者长期功能预后的影响.方法采用回顾性病例对照研究的方法比较颅脑创伤去骨瓣减压术后行早期的颅骨修补术(＜2个月)患者与术后行常规颅骨修补术(＞3个月)患者长期预后的差异,从而评价早期颅骨修补对于颅脑创伤行去骨瓣减压术患者的预后影响.早期颅骨修补组与延期颅骨修补组各23例,病例根据性别、年龄、颅脑创伤的严重程度及修补术前预后水平1:1配对.结果比较外伤后15个月患者的预后水平,早期颅骨修补组(GOS:4.3±0.9;KPS:73.9±22.5)较延期颅骨修补组(GOS:3.8±1.0;KPS:62.6±24.2)有显著提高.结论在掌握适应证的情况下去骨瓣减压后早期行颅骨修补术对患者预后的改善安全有效.
목적 분석로뇌창상후거골판감압술후조기로골수보대환자장기공능예후적영향.방법 채용회고성병례대조연구적방법비교로뇌창상거골판감압술후행조기적로골수보술(＜2개월)환자여술후행상규로골수보술(＞3개월)환자장기예후적차이,종이평개조기로골수보대우로뇌창상행거골판감압술환자적예후영향.조기로골수보조여연기로골수보조각23례,병례근거성별、년령、로뇌창상적엄중정도급수보술전예후수평1:1배대.결과 비교외상후15개월환자적예후수평,조기로골수보조(GOS:4.3±0.9;KPS:73.9±22.5)교연기로골수보조(GOS:3.8±1.0;KPS:62.6±24.2)유현저제고.결론 재장악괄응증적정황하거골판감압후조기행로골수보술대환자예후적개선안전유효.
Objectives This study was performed to ascertain whether early cranioplasty could improve the outcomes in patients with large cranial defects resulted from decompressive surgery after severe head trauma. Methods In this study,a case control cohort study was performed to compare the outcomes of the patients (23 cases) who underwent early cranioplasty ranged from 5 to 8 weeks ( ＜ 2 months) after decompressive craniectomy due to severe traumatic brain injuries with those of the patients (23 cases) undergoing the same procedure within a traditional duration. The data of age,gender and severity of the head trauma were well compared between early cranioplasty group and delayed cranioplasty group. Results There were no differences in patients' demographics,degree of head trauma,types of CT classification,therapy intensity level,size of cranial defects,complications secondary to cranioplasty and therapy for rehabilitation between two groups as well. And 15 months after head trauma,the prognosis of early cranioplasty group (GOS:4.3±0.9;KPS:73.9±22.5) was better than that of delayed cranioplasty group (GOS: 3.8±1.0 ; KPS : 62.6±24.2 ) with significant differences statistically ( GOS : P = 0. 022 ; KPS : P = 0.035 ).Conclusion Early cranioplaty for large cranial defects by decompressive craniectomy is safe and helpful to improve the patients' prognosis,and may contribute to better outcomes than late cranioplasty.