Journal of Mazandaran University of Medical Sciences
مجله دانشگاه علوم پزشکی مازندران
J Mazandaran Univ Med Sci
Medical Sciences
http://jmums.mazums.ac.ir
1
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1735-9260
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1401
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2022
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بررسی مقایسه ای بروز عوارض بعد از جراحی کرانیوپلاستی زودرس و تاخیری در بیمارستان شهید باهنر کرمان (1397-1394) :
یک مطالعه همگروهی گذشته نگر
Comparative Study of Complications After Early and Late Cranioplasty in Kerman Shahid Bahonar Hospital, 2015-2018: A Retrospective Cohort Study
جراحي مغز و اعصاب
neurosurgery
گزارش کوتاه
Brief Report
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:92%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="FA" style="line-height:92%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">سابقه</span></span></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt"> و هدف:</span></span></span></span> <span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">عمل جراحی کرانیوپلاستی شامل استفاده از فلپ جمجمه اتولوگ بیمار جهت بازسازی بافت استخوانی </span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar"">جمجمه میباشد ودر برخی موارد بعد از جراحی کرانیکتومی دکمپرسیو، اندیکاسیون دارد. طبق </span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">پژوهش</span></span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">های قبلی به نظر می</span></span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">رسد بروز عوارض بعد از کرانیوپلاستی با زمان انجام آن مرتبط باشد. این پژوهش با هدف مقایسه عوارض کرانیوپلاستی زودرس (</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%"><span style="color:black"><span style="letter-spacing:-.2pt">EC</span></span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">) و تاخیری (</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%"><span style="color:black"><span style="letter-spacing:-.2pt">LC</span></span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">) در بیماران جراحی کرانیکتومی در بیمارستان شهید باهنر کرمان از سال 1394 تا 1397 اجرا شد.</span></span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:#0e101a"></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:92%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">مواد و روش</span></span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.1pt"></span></span></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.1pt">ها:</span></span></span></span> <span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.1pt">این </span></span></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">مطالعه کوهورت گذشته</span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt"></span></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">نگر به روش پرونده خوانی اجرا شد. با همسان</span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt"></span></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""><span style="letter-spacing:-.1pt">سازی از نظر سن و جنسیت،</span></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""> نمونه</span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar"">های دو گروه </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%">EC</span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""> (45 نفر) و </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%">LC</span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""> (46) انتخاب و از نظر فراوانی بروز عوارض بعد از عمل کرانیوپلاستی مقایسه شدند. آنالیز داده</span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar"">ها با نرم</span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar"">افزار25 </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%">SPSS</span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""> انجام شد.</span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:92%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">یافته</span></span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">ها:</span></span></span></span> <span lang="AR-SA" style="font-family:"B Zar""><span style="letter-spacing:-.2pt">دو گروه از نظر سن </span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">(0/846</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%"><span style="color:black"><span style="letter-spacing:-.2pt">P=</span></span></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">)</span></span></span></span><b> </b><span lang="AR-SA" style="font-family:"B Zar""><span style="letter-spacing:-.2pt">و جنسیت </span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">(0/185</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%"><span style="color:black"><span style="letter-spacing:-.2pt">P=</span></span></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">)</span></span></span></span><b> </b><span lang="AR-SA" style="font-family:"B Zar""><span style="letter-spacing:-.2pt">تفاوت آماری معنی<span style="color:black"></span>دار نداشتند و شایع<span style="color:black"></span>ترین اندیکاسیون کرانیکتومی در آن<span style="color:black"></span>ها خونریزی ساب دورال </span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">بود. </span></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">ارتباطی بین نوع تشخیص منجر به کرانیکتومی با نوع کرانیوپلاستی یافت نشد (0/493=</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%"><span style="font-family:"Cambria Math","serif""><span style="letter-spacing:-.2pt">P</span></span></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">)</span></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""><span style="letter-spacing:-.2pt">. </span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">و گروه از نظر نمره مقیاس کمای گلاسکو (</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%"><span style="color:black"><span style="letter-spacing:-.2pt">GCS</span></span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">) قبل از عمل (</span></span></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">0/841</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%"><span style="color:black"><span style="letter-spacing:-.2pt">P=</span></span></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">) و بعد از عمل</span></span></span></span> <span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">(0/148</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%"><span style="color:black"><span style="letter-spacing:-.2pt">P=</span></span></span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">) تفاوت نداشتند</span></span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt"> و از نظر فراوانی بروز عوارض مشابه بودند(0/05</span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%"><span style="color:black"><span style="letter-spacing:-.2pt">P></span></span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">)، که شامل هماتوم (3 مورد در هر دو گروه)، هیدروسفالی (2 مورد در گروه </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%"><span style="color:black"><span style="letter-spacing:-.2pt">EC</span></span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt"> و یک مورد در گروه </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%"><span style="color:black"><span style="letter-spacing:-.2pt">LC</span></span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">) و اختلال در ترمیم زخم (دو مورد در گروه </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%"><span style="color:black"><span style="letter-spacing:-.2pt">EC</span></span></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt">) بود.</span></span></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:92%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Koodak""><span style="color:black"><span style="letter-spacing:-.2pt">استنتاج:</span></span></span></span> <span lang="FA" style="line-height:92%"><span style="font-family:"B Zar"">به نظر می</span></span><span lang="AR-SA" style="font-family:"B Zar""><span style="color:black"></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar"">رسد جراحان مغز و اعصاب می</span></span><span lang="AR-SA" style="font-family:"B Zar""><span style="color:black"></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar"">توانند هر یک از دو رویکرد </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%">EC</span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""> و </span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:92%">LC</span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""> را متناسب با شرایط بیمار به</span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar""></span></span><span lang="FA" style="line-height:92%"><span style="font-family:"B Zar"">کار ببرند.</span></span><span lang="AR-SA" style="line-height:92%"><span style="font-family:"B Zar""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span></span></span></span></span></span></span></span><br>
<strong> </strong><span style="font-size:12pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:"><span style="letter-spacing:-.2pt">Background and purpose:</span></span></span></span></b><span style="font-size:10.0pt"><span style="line-height:150%"> Cranioplasty after craniotomy is done to repair the skull and in some cases decompressive craniectomy is performed. Previous studies showed that the incidence of complications after cranioplasty is associated with the time of occurrence. The aim of this study was to compare the rate of complications between early cranioplasty (EC) and late cranioplasty (LC) in craniectomy patients in Kerman Shahid Bahonar Hospital, 2015-2018.</span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:150%"><span style="text-autospace:none"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:">Materials and methods:</span></span></span></b><b> </b><span style="font-size:10.0pt"><span style="line-height:150%">In a retrospective cohort study, patients’ records were studied and the subjects were matched for age and sex. Then, frequency of complications was compared between patients with EC (n=45) and LC (n=46). Data analysis was applied in SPSS V25. </span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:150%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:"><span style="color:black">Results: </span></span></span></span></b><span style="font-size:10.0pt"><span style="line-height:150%"><span style="color:black">There were </span></span></span><span style="font-size:10.0pt"><span style="line-height:150%"><span style="color:black">no significant differences between the two groups in age and sex<br>
(P= 0.846 and P= 0.185, respectively). The most common indication for craniotomy was subdural hemorrhage and the most common complication was hematoma. No significant association was found between the indication for surgery and type of cranioplasty (P=0.493). The two groups did not have significant differences in Glasgow Coma Scale (GCS) score before and after the surgery (P=0.841 and P=0.148, respectively) and were found to be similar in frequency of complications (P>0.05), including hematoma (three cases in each group), hydrocephalus (two cases in EC and one case in LC), and wound healing impairment (two cases in EC).</span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:150%"><span style="vertical-align:top"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:150%"><span arial="" style="font-family:">Conclusion:</span></span></span></b> <span style="font-size:10.0pt"><span style="line-height:150%">According to current study, neurosurgeons, depending on the patient's condition, can use either EC or LC.</span></span><i><span style="font-size:10.0pt"><span style="line-height:150%"></span></span></i></span></span></span></span><br>
کرانیوپلاستی زودرس, کرانیوپلاستی دیررس, عوارض بعد از عمل جراحی, مطالعه همگروهی
early cranioplasty, late cranioplasty, complications, cohort study
194
199
http://jmums.mazums.ac.ir/browse.php?a_code=A-10-14336-2&slc_lang=fa&sid=1
Mohsen
Shahba
محسن
شهبا
msneurosurgeon@gmail.com
1003194753284600145010
1003194753284600145010
No
Assistant Professor, Department of Neurosurgery, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
استادیار جراحی مغز و اعصاب، گروه جراحی مغز و اعصاب، دانشکده پزشکی، دانشگاه علوم پزشکی کرمان، کرمان، ایران
Peyman
Daneshvar
پیمان
دانشور
farahbaksh3@gmail.com
1003194753284600145011
1003194753284600145011
No
Resident in Neurosurgery, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
دستیار بالینی جراحی مغز و اعصاب، گروه جراحی مغز و اعصاب، دانشکده پزشکی، دانشگاه علوم پزشکی کرمان، کرمان، ایران
Alireza
Ghaedamini
علی رضا
قائدامینی
alirezaghaedamini@gmail.com
1003194753284600145012
1003194753284600145012
No
Resident in Neurosurgery, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
دستیار بالینی جراحی مغز و اعصاب، گروه جراحی مغز و اعصاب، دانشکده پزشکی، دانشگاه علوم پزشکی کرمان، کرمان، ایران
Hossein
Ghaedamini
حسین
قائدامینی
Ghaedaminih@gmail.com
1003194753284600145013
1003194753284600145013
Yes
Resident in General Surgery, Faculty of Medicine, Jundishapur University of Medical Sciences, Ahvaz, Iran
دستیار بالینی جراحی عمومی، گروه بیماری های جراحی، دانشکده پزشکی، دانشگاه علوم پزشکی جندی شاپور، اهواز، ایران