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早期颅骨修补术对认知和功能障碍恢复的影响。

Effects of Early Cranioplasty on the Restoration of Cognitive and Functional Impairments.

作者信息

Kim Byung Wook, Kim Tae Uk, Hyun Jung Keun

机构信息

Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea.

Department of Nanobiomedical Science & WCU Research Center, Dankook University, Cheonan, Korea.

出版信息

Ann Rehabil Med. 2017 Jun;41(3):354-361. doi: 10.5535/arm.2017.41.3.354. Epub 2017 Jun 29.

Abstract

OBJECTIVE

To delineate the effect of early cranioplasty on the recovery of cognitive and functional impairments in patients who received decompressive craniectomy after traumatic brain injury or spontaneous cerebral hemorrhage.

METHODS

Twenty-four patients who had received cranioplasty were selected and divided according to the period from decompressive craniectomy to cranioplasty into early (≤90 days) and late (>90 days) groups. The Korean version of the Mini-Mental State Examination (K-MMSE), Korean version of the Modified Barthel Index (K-MBI), and Functional Independence Measure (FIM) were evaluated at admission just after decompressive craniectomy and during the follow-up period after cranioplasty.

RESULTS

Twelve patients were included in the early group, and another 13 patients were included in the late group. The age, gender, type of lesion, and initial K-MMSE, K-MBI, and FIM did not significantly differ between two groups. However, the total gain scores of the K-MMSE and FIM in the early group (4.50±7.49 and 9.42±15.96, respectively) increased more than those in the late group (-1.08±3.65 and -0.17±17.86, respectively), and some of K-MMSE subscores (orientation and language) and FIM subcategories (self-care and transfer-locomotion) in the early group increased significantly when compared to those in the late group without any serious complications. We also found that the time to perform a cranioplasty was weakly, negatively correlated with the K-MMSE gain score (r=-0.560).

CONCLUSION

Early cranioplasty might be helpful in restoring cognitive and functional impairments, especially orientation, language ability, self-care ability, and mobility in patients with traumatic brain injury or spontaneous cerebral hemorrhage.

摘要

目的

探讨早期颅骨修补术对创伤性脑损伤或自发性脑出血后接受减压性颅骨切除术患者认知和功能障碍恢复的影响。

方法

选取24例行颅骨修补术的患者,根据减压性颅骨切除术后至颅骨修补术的时间分为早期组(≤90天)和晚期组(>90天)。在减压性颅骨切除术后即刻入院时以及颅骨修补术后随访期间,评估韩国版简易精神状态检查表(K-MMSE)、韩国版改良巴氏指数(K-MBI)和功能独立性测量量表(FIM)。

结果

早期组纳入12例患者,晚期组纳入另外13例患者。两组患者的年龄、性别、病变类型以及初始K-MMSE、K-MBI和FIM无显著差异。然而,早期组K-MMSE和FIM的总增益分数(分别为4.50±7.49和9.42±15.96)比晚期组(分别为-1.08±3.65和-0.17±17.86)增加更多,并且早期组的一些K-MMSE子分数(定向和语言)和FIM子类别(自我护理和转移-移动)与晚期组相比显著增加,且无任何严重并发症。我们还发现,进行颅骨修补术的时间与K-MMSE增益分数呈弱负相关(r=-0.560)。

结论

早期颅骨修补术可能有助于恢复创伤性脑损伤或自发性脑出血患者的认知和功能障碍,尤其是定向、语言能力、自我护理能力和活动能力。

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