Early cranioplasty versus traditional cranioplasty enhances surgical outcomes in patients with malignant cerebral infarction after decompressive craniectomy.

IF 1.8 3区 医学 Q2 SURGERY
Zhifeng Yan, Zecheng Xue, Maolin Wang, Linjun Wang, Hongmin Che, Zhongnan Yan
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引用次数: 0

Abstract

Background: A growing cohort of malignant cerebral infarction (MCI) patients after decompressive craniectomy (DC) required cranioplasty (CP). However, few studies have reported the effect of CP on functional improvements in post-DC MCI patients. The aim of this study was to determine whether early CP for post-DC MCI patients enhances surgical outcomes and alters overall complication rate.

Methods: 86 post-DC MCI patients after CP were divided into the early CP cohort and the traditional CP cohort according to the time span from DC to CP. Complications, NIHSS, mBI, mRS, and CRS-r were assessed, and early CP and traditional CP were defined as occurring less than or more than 3 months after DC.

Results: Complications were observed in 9 patients (24.32%) in the early CP cohort and 14 patients (28.57%) in the traditional CP cohort (p > 0.05). NIHSS, mRS, mBI, and CRS-r between pre-operation and post-operation did significantly differ (p < 0.05). Between the two cohorts, operative time, intraoperative blood loss, post-operative parameters (NIHSS, mBI and mRS), ∆NIHSS, and ∆mBI did significantly differ (p < 0.05), while post-operative CRS-r did not significantly differ (p > 0.05). There was a linear relationship between ∆NIHSS and the time span from DC to CP (r = 0.505, p < 0.0001), and there was a linear relationship between ∆BI and the time span from DC to CP (r = -0.568, p < 0.0001).

Conclusions: Our study demonstrated that, first, CP has a favorable effect on improving neurological function, ability to perform daily living, and consciousness in post-DC MCI patients; second, early CP does not alter the overall complication rate and is as safe as traditional CP; third, compared to traditional CP, early CP reduces operative time and intraoperative blood loss, promotes improvements in neurological function and ability to perform daily living, and enhances these improvements.

早期颅骨成形术与传统颅骨成形术相比可提高恶性脑梗死患者减压颅骨切除术后的手术效果。
背景:越来越多的恶性脑梗死(MCI)患者在减压颅骨切除术(DC)后需要颅骨成形术(CP)。然而,很少有研究报道CP对dc后MCI患者功能改善的影响。本研究的目的是确定早期CP对dc后MCI患者是否能提高手术效果并改变总体并发症发生率。方法:86例CP后DC后MCI患者根据从DC到CP的时间跨度分为早期CP组和传统CP组,评估并发症、NIHSS、mBI、mRS、CRS-r,并将早期CP和传统CP定义为发生时间小于或大于DC后3个月。结果:早期CP组9例(24.32%)出现并发症,传统CP组14例(28.57%)出现并发症(p < 0.05)。术前、术后NIHSS、mRS、mBI、CRS-r差异有统计学意义(p < 0.05)。∆NIHSS与从DC到CP的时间跨度呈线性关系(r = 0.505, p)。结论:首先,CP对DC后MCI患者的神经功能、日常生活能力和意识的改善有良好的作用;其次,早期CP不会改变总体并发症发生率,与传统CP一样安全;第三,与传统CP相比,早期CP减少了手术时间和术中出血量,促进了神经功能和日常生活能力的改善,并增强了这些改善。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Surgery
BMC Surgery SURGERY-
CiteScore
2.90
自引率
5.30%
发文量
391
审稿时长
58 days
期刊介绍: BMC Surgery is an open access, peer-reviewed journal that considers articles on surgical research, training, and practice.
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