发展中国家一家三甲医院的颅骨成形术疗效

IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL
Annals of African Medicine Pub Date : 2024-04-01 Epub Date: 2024-05-01 DOI:10.4103/aam.aam_53_23
Sultan Jarrar, Mohammad Al Barbarawi, Suleiman Shaheer Daoud, Amer Jaradat, Osama Darabseh, Khaled El-Muwalla, Maram Husenat
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引用次数: 0

摘要

背景:减压开颅术(DC)是一种治疗难治性颅内压增高的手术方法。颅骨成形术(CP)是一种重建手术,用于保护大脑底层和维持脑脊液流动动态,通常会取代减压性颅骨切除术。然而,CP 可引起癫痫发作、积液、感染和脑积水等并发症。我们的目的是调查这些并发症及其可能的风险因素,并讨论早期或晚期 CP 是否会对结果产生影响:我们进行了一项单中心回顾性队列研究,研究对象包括 2014 年 1 月至 2022 年 1 月期间在 DC 后接受 CP 的患者。研究收集了相关信息,如人口统计学、脑损伤类型、CP 使用的材料、DC 和 CP 之间的时间间隔以及术后并发症。最终,63 名患者被纳入我们的研究。我们还比较了 DC 术后晚期 CP(超过 90 天)患者与早期 CP 患者之间的并发症发生率(结果:大多数患者为男性(78%)。样本年龄中位数为 29 岁,其中儿科患者占 36%。总体并发症发生率为 57%,50% 的患者出现癫痫发作/癫痫,28% 的患者出现积液,25% 的患者出现感染,17% 的患者出现外伤后脑积水,3% 的患者出现骨缺损/骨吸收。22%出现并发症的患者需要再次手术,并接受第二次CP治疗。开颅手术与CP之间的中位(四分位间距)持续时间为56(27-102)天,早期(≤3个月)的比例为68%。我们发现早期(≤3个月)和晚期(>3个月)CP在并发症发生率方面没有明显差异:结论:尽管 CP 是一种简单的手术,但其并发症发生率相当高。因此,外科医生必须充分了解这些并发症,才能更有效地应对这些挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cranioplasty Outcomes from a Tertiary Hospital in a Developing Country.

Background: Decompressive craniectomy (DC) is a surgical procedure to treat refractory increase in intracranial pressure. DC is frequently succeeded by cranioplasty (CP), a reconstructive procedure to protect the underlying brain and maintain cerebrospinal fluid flow dynamics. However, complications such as seizures, fluid collections, infections, and hydrocephalus can arise from CP. Our aim is to investigate these complications and their possible risk factors and to discuss whether early or late CP has any effect on the outcome.

Materials and methods: A single-center retrospective cohort study was performed, including patients who underwent CP after DC between January 2014 and January 2022. Relevant information was collected such as demographics, type of brain injury, materials used in CP, timing between DC and CP, and postoperative complications. Ultimately, 63 patients were included in our study. We also compared the complication rate between patients who underwent late CP after DC (>90 days) against patients who underwent early CP (<90 days).

Results: Most patients were male (78%). The sample median age was 29 years, with pediatric patients, accounting for 36% of the samples. Overall complication rate was 57% and they were seizure/epilepsy in 50% of the patients, fluid collection (28%), infections (25%), posttraumatic hydrocephalus (17%), and bone defect/resorption (3%). Twenty-two percent of patients with complications required reoperation and underwent a second CP. The median (interquartile range) duration between the craniotomy and the CP was 56 (27-102) days, with an early (≤3 months) percentage of 68%. We found no significant difference between early (≤3 months) and late (>3 months) CP regarding complication rates.

Conclusion: Despite CP being a simple procedure, it has a considerable rate of complications. Therefore, it is important that surgeons possess adequate knowledge about such complications to navigate these challenges more effectively.

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来源期刊
Annals of African Medicine
Annals of African Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
0.90
自引率
0.00%
发文量
31
期刊介绍: The Annals of African Medicine is published by the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria and the Annals of African Medicine Society. The Journal is intended to serve as a medium for the publication of research findings in the broad field of Medicine in Africa and other developing countries, and elsewhere which have relevance to Africa. It will serve as a source of information on the state of the art of Medicine in Africa, for continuing education for doctors in Africa and other developing countries, and also for the publication of meetings and conferences. The journal will publish articles I any field of Medicine and other fields which have relevance or implications for Medicine.
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