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非综合征性和综合征性颅缝早闭的长期预后:分析人口统计学、形态学和手术因素。

Long-term Outcomes of Non-syndromic and Syndromic Craniosynostosis: Analysis of Demographic, Morphologic, and Surgical Factors.

机构信息

Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Science, University of Toyama.

Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Kanazawa Medical University.

出版信息

Neurol Med Chir (Tokyo). 2022 Feb 15;62(2):57-64. doi: 10.2176/nmc.oa.2021-0101. Epub 2021 Oct 27.

Abstract

In this study, we analyzed the outcomes of patients (followed for 5-38 years, average 17.3 years) with craniosynostosis and evaluated their long-term prognosis. In all, 51 patients who underwent surgery for craniosynostosis between 1982 and 2015, including 12 syndromic and 39 non-syndromic cases, were included. The average age at the initial surgery was significantly lower in the syndromic group than that in the non-syndromic group (9.8 months old vs. 19.9 months, respectively). The surgical procedures did not significantly differ between the two groups, but repeat surgery was significantly more common in the syndromic group than in the non-syndromic group (4 children [30.8%] and 3 children [7.7%], respectively). The children requiring repeat surgery tended to be younger at the initial surgery than those who did not. Those patients who required repeat surgery did not have significantly different surgical procedures initially. The incidence of developmental retardation was 49.0% (43.5% in the non-syndromic group and 66.7% in the syndromic group), and only two children in the non-syndromic group displayed recovery. This study is the first to analyze the prognosis for patients who were followed for at least 5 years after cranioplasty. Repeat surgery was common, especially in syndromic patients. Severity of skull deformity and early initial surgery may be important factors determining the need for repeat surgery. Developmental retardation was also common, and improvement was rare even after surgery.

摘要

在这项研究中,我们分析了患有颅缝早闭症患者的治疗结果(随访 5-38 年,平均 17.3 年),并评估了他们的长期预后。共有 51 例颅缝早闭患者在 1982 年至 2015 年间接受了手术治疗,包括 12 例综合征患者和 39 例非综合征患者。综合征组患者的初次手术年龄明显低于非综合征组(分别为 9.8 个月和 19.9 个月)。两组患者的手术方式没有显著差异,但综合征组的再次手术更为常见(分别为 4 例儿童[30.8%]和 3 例儿童[7.7%])。需要再次手术的儿童初次手术时往往年龄较小。需要再次手术的患者最初的手术方式没有明显差异。发育迟缓的发生率为 49.0%(非综合征组为 43.5%,综合征组为 66.7%),仅有 2 例非综合征组患者出现恢复。本研究首次分析了颅骨成形术后至少随访 5 年的患者的预后。再次手术很常见,尤其是在综合征患者中。颅骨畸形的严重程度和早期初次手术可能是决定是否需要再次手术的重要因素。发育迟缓也很常见,即使手术后也很少有改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77fc/8841231/0c2d591ea4ff/nmc-62-57-g1.jpg

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