Department of Neurosurgery, Lianyungang First People's Hospital Lianyungang, Jiangsu, China.
Medicine (Baltimore). 2024 Nov 1;103(44):e39727. doi: 10.1097/MD.0000000000039727.
To analyze the efficacy of early cranioplasty in patients with traumatic brain injury and its impact on neurological function, stress response, and cognitive function. A total of 90 patients with traumatic brain injury admitted to the hospital from January 2021 to March 2024 were included in the study. The patients were divided into an observation group (45 cases) and a control group (45 cases) based on the timing of their cranioplasty. The control group underwent cranioplasty 3 to 6 months post-trauma, while the observation group received cranioplasty within 3 months post-trauma. Neurological function was assessed using the National Institutes of Health Stroke Scale. Cognitive function was evaluated using the Functional Independence Measure, Mini-Mental State Examination, and Neurobehavioral Cognitive Status Examination. Blood samples were collected to measure and compare serum levels of interleukin-6, cortisol, and tumor necrosis factor-alpha between the 2 groups. The observation group demonstrated a higher rate of excellent recovery compared to the control group (95.56% vs 80.00%), with significantly lower National Institutes of Health Stroke Scale scores ([11.18 ± 2.35] vs [14.74 ± 3.61], P < .05). Posttreatment scores for Functional Independence Measure, Mini-Mental State Examination, and Neurobehavioral Cognitive Status Examination were significantly higher in the observation group compared to the control group ([59.26 ± 6.12] vs [47.86 ± 5.27], [25.02 ± 4.61] vs [22.74 ± 5.13], [103.52 ± 10.63] vs [88.76 ± 7.39], P < .05). Serum levels of interleukin-6, cortisol, and tumor necrosis factor-alpha were significantly lower in the observation group ([22.76 ± 4.15] ng/mL vs [25.38 ± 5.27] ng/mL, [66.29 ± 4.91] nmol/L vs [78.24 ± 6.08] nmol/L, [3.36 ± 1.02] ng/mL vs [4.91 ± 0.98] ng/mL, P < .05). The total incidence of postoperative complications was significantly lower in the observation group (8.70% vs 26.09%, P < .05). Early cranioplasty is beneficial for the postoperative recovery of patients with traumatic brain injury. It improves neurological function, enhances cognitive function, and reduces stress response, while also significantly lowering the incidence of postoperative complications.
分析早期颅骨修补术对创伤性脑损伤患者的疗效及其对神经功能、应激反应和认知功能的影响。将 2021 年 1 月至 2024 年 3 月期间收治的 90 例创伤性脑损伤患者纳入研究。根据颅骨修补术的时间，患者分为观察组（45 例）和对照组（45 例）。对照组在创伤后 3 至 6 个月行颅骨修补术，观察组则在创伤后 3 个月内行颅骨修补术。采用美国国立卫生研究院卒中量表评估神经功能。采用功能独立性测量量表、简易精神状态检查量表和神经行为认知状态检查量表评估认知功能。采集血样，比较两组患者血清白细胞介素-6、皮质醇和肿瘤坏死因子-α水平。观察组的恢复优良率明显高于对照组（95.56% vs 80.00%），美国国立卫生研究院卒中量表评分明显更低[（11.18 ± 2.35） vs （14.74 ± 3.61），P <.05]。观察组治疗后的功能独立性测量量表、简易精神状态检查量表和神经行为认知状态检查量表评分明显高于对照组[（59.26 ± 6.12） vs （47.86 ± 5.27），（25.02 ± 4.61） vs （22.74 ± 5.13），（103.52 ± 10.63） vs （88.76 ± 7.39），P <.05]。观察组的血清白细胞介素-6、皮质醇和肿瘤坏死因子-α水平明显更低[（22.76 ± 4.15）ng/mL vs （25.38 ± 5.27）ng/mL，（66.29 ± 4.91）nmol/L vs （78.24 ± 6.08）nmol/L，（3.36 ± 1.02）ng/mL vs （4.91 ± 0.98）ng/mL，P <.05]。观察组的术后并发症总发生率明显更低（8.70% vs 26.09%，P <.05）。早期颅骨修补术有利于创伤性脑损伤患者术后恢复，能改善神经功能，增强认知功能，降低应激反应，且显著降低术后并发症发生率。
