Clinical Study Of Ultra Early Three Dimensional Titanium Mesh Cranioplasty After Decompressive Craniectomy

Objectiveo:investigate the severe brain injury after decompressive surgery of skull defects ultra-early(4-6weeks)the feasibility of row three-dimensional titanium mesh skull patch and its impact on the long-term prognosis of patients,and to explore ultra-early skull repair surgery Are compared with conventional surgery exist advantages.Methods:To retrospect analysis of January 2012-January 2015 period,after craniocerebral injury in patients with skull defect repair 99 cases.According to the time of skull repair after decompression,the time interval of the skull repair was divided into two groups: the early group(4-6 weeks)and the conventional group(3-6 months).The patients were divided into two groups according to the GOS score,KPS score and NIHSS score.The two groups were compared with the two groups of patients after the skull repair Quality of life.Results:The amount of blood loss in the patients with early stage(285.87 ± 23.5)ml,and the flap separation time was(13.4 ± 1.27)min.(535.66 ± 31.2)ml and(47.5 ± 2.43)min,respectively.The time of the flap was longer than that of the super early group.The difference was statistically significant(P<0.05).In the early stage,the amount of bleeding was significantly reduced,the risk of reoperation was reduced,the economic burden of the patients was reduced,the time of anesthesia was shortened,and the intraoperative performance was significantly better than that of the conventional group.The scores of GOS,KPS and NIHSS were(2.8 ± 0.7),(53.3 ± 7.6)and(6.2 ± 0.1)in the early postoperative patients.The GOS score,KPS score and NIHSS score were(2.8 ± 0.4),(52.1 ± 4.7)and(6.1 ± 0.3)in the conventional group.There was no significant difference between the two groups(P> 0.05).The scores of GOS,KPS and NIHSS were(3.9 ± 0.3),(64.5 ± 7.1)and(4.1 ± 0.2)in the early postoperative group.The scores of GOS,KPS and NIHSS were(3.1 ± 0.4),(55.5 ± 6.3)and(5.8 ± 0.3)in the conventional group.The data of each group were statistically significant(P<0.05).The scores of GOS,KPS and NIHSS were(4.2 ± 0.1),(75.3 ± 6.4)and(2.5 ± 0.9),respectively.The GOS score,KPS score and NIHSS score were(3.8 ± 0.2),(67.5 ± 6.2)and(3.9 ± 0.9)in the conventional group.The data of each group were statistically significant(P<0.05).In the ultra-early skull repair group,52 cases had sub-dural effusion.In the conventional group,5 cases had subdural effusion,and the ratio of the super-early group was significantly lower than that of the conventional group.The difference was statistically significant(P<0.05).There were 5 cases of complications such as subdural effusion in the early group of 52 cases.There were no significant differences in the complication rate between the conventional group and the conventional group(P> 0.05).Conclusion : Severe brain injury patients after decompression craniectomy in the ultra-early(4-6 weeks)skull patch is clinically safe and effective,it can improve patient outcomes and reduce the probability of occurrence of postoperative complications,and can reduce blood loss during surgery scalp peeling time shortened.