早期颅骨修补联合脑室腹腔分流术治疗脑外伤患者的临床效果观察

摘要

目的：探讨早期颅骨修补联合脑室腹腔分流术治疗脑外伤患者的临床效果。方法将本院收治的55例颅脑外伤去骨瓣减压术后并发脑积水患者分为两组，观察组27例，在开颅血肿清除术后3个月左右同期行颅骨修补联合脑室腹腔分流术；对照组28例，早期行脑室腹腔分流术，3~6个月后再行颅骨修补术，比较两组的临床疗效及术后并发症发生率。结果观察组的致残率为37.03%，明显低于对照组的64.29%，差异有统计学意义(P<0.05)；两组的恢复良好比较差异有统计学意义(P<0.05)；两组的植物状态与死亡比较差异无统计学意义(P>0.05)。观察组的术后积液及血肿发生率低于对照组，差异有统计学意义(P<0.05)；两组的术后感染、分流过度和分流管阻塞比较差异无统计学意义(P>0.05)。结论早期颅骨修补联合脑室腹腔分流术能明显促进患者神经系统功能恢复，提高患者的生活质量，且有助于减少并发症的发生。%Objective To investigate clinical effect of early repair of traumatic skull combined with ventricle peritoneal shunt in the treatment of patients with traumatic brain injury. Methods 55 cases of patients with the decompressive craniectomy and hydrocephalus were divided into two groups.The repair of traumatic skull combined with ventricle peritoneal shunt after decompressive craniectomy 3 months were used in observation group (27 cases).Ventriculo-peri-toneal shunt first after decompressive craniectomy and cranioplasty after 3-6 months were used in control group (28 cases).The clinical efficacy and incidence rate of complication in two groups was compared respectively. Results Dis-ability rate in observation group was 37.03%,significantly lower than that in control group (64.29%),with statistical dif-ference(P<0.05).Good recovery in two groups was compared,with statistical difference(P<0.05).The plant state and death in two groups was compared,with no statistical difference (P>0.05).The incidence rate of postoperative seroma and hematoma in observation group was lower than that in control group,with statistical difference(P<0.05).Postoperative in-fection,shunt excessive and shunt tube obstruction in two groups was compared respectively,with no statistical difference (P>0.05). Conclusion Early repair of traumatic skull combined with ventricle peritoneal shunt can obviously promote the function recovery in patients with nervous system,improve the quality of life of patients,and help to reduce the oc-currence of complication.