Effect Of Early Skull Repair On Neurological Recovery In Patients With Cranial Defects After Standard Large Bone Flap Decompression

Objective This study compares the intraoperative and postoperative indicators of patients undergoing cranioplasty in different periods,and explores the effect of early cranial repair on postoperative neurological recovery in patients with cranial defects after standard large bone flap decompression.The formulation of surgical plans and the selection of other adjuvant treatment plans provide a basis for further reference for clinicians and patients.Methods Through retrospective analysis,56 patients with cranial defects after standard large bone flap decompression after admission in the People’s Hospital of Inner Mongolia Autonomous Region from September 2017 to May 2019 were selected as the research objects,and the bone flap was reduced according to the distance of skull repair.The time of compression surgery was divided into two groups,that is,the early group(skull repair in 1-3 months after surgery)and the conventional group(skull repair in 3 months after surgery).A digital three-dimensionally shaped titanium mesh was used for skull repair.The postoperative neurological recovery was compared between the two groups by GCS,GOS,and ADL scores at 1 month,3 months,and 12 months after surgery.The intraoperative conditions and postoperative complications of the two groups of patients were analyzed.Data were analyzed using SPSS 24.0 statistical software.Measurement data were expressed as mean ± standard deviation(?)and analyzed using t-test.Count data were analyzed using chi-square test.The above tests were performed at α = 0.05,and p <0.05 was considered statistically significant.Results The average operation time of patients undergoing early craniotomy was(89.77±3.96min),the average blood loss during operation was(306.5±42.24ml),and the average time of free flap was(25.77±2.96min).The operation time,intraoperative blood loss,and flap free time were longer than those in the early group,with an average of(127.67±5.04min),(443.67±37.28ml),and(42.27±7.57min).There were differences between the two groups.Statistical significance(p <0.05),suggesting that early repair is better than conventional repair.Comparing the GCS,GOS,and ADL scores of the two groups at 1 month,3 months,and 12 months after repair,the scores of patients in the conventional group were significantly lower than those in the early group,and the difference was statistically significant(p <0.05).There were 0 cases of wound infection,0 cases of subdural effusion,and 0 cases of subdural hematoma in the early group.The incidence of complications in this group was 0.In the conventional group,1 case of wound infection and dura mater appeared.There were 2 cases of lower effusion and 0 cases of subdural hematoma.The incidence of complications in this group was 10%.The incidence of complications was significantly higher in patients in the conventional group than in early patients.The difference was statistically significant(p <0.05).Surgery is better than advanced surgery.Conclusion For patients with cranial bone defects after standard large bone flap decompression,timely repair the defective skull,restore the cranial cavity as soon as possible,and perform cranioplasty as soon as possible is beneficial to the patient.On the premise of no concurrent infection and stable injury,surgery should be performed as soon as possible.