脑外伤并脑积水采用早期颅骨修补联合脑室-腹腔分流治疗的疗效分析.docVIP

精品论文 参考文献 脑外伤并脑积水采用早期颅骨修补联合脑室-腹腔分流治疗的疗效分析 宁乡县人民医院神经外科 湖南宁乡 410600 【摘 要】目的：分析脑外伤并脑积水采用早期颅骨修补联合脑室-腹腔分流治疗的疗效。方法：回顾性分析86例脑外伤并脑积水患者的临床资料，根据颅骨修补时间进行分组；对照组41例，先采用脑室-腹腔分流治疗，2个月后，采用颅骨修补治疗；观察组45例，采用早期（2个月内）颅骨修补联合脑室-腹腔分流治疗；对比两组患者的手术治疗、疗效及预后情况。结果：观察组患者手术时间、皮瓣游离时间均短于对照组，术中出血量少于对照组，并发症发生率小于对照组，经T或chi;2检验，差异具有统计学意义（P＜0.05）；手术后，观察组患者GCS评分、ADL评分、Fugl-Meyer评分均较对照组明显升高，经T检验，差异具有统计学意义（P＜0.05）。结论：早期颅骨修补联合脑室-腹腔分流治疗脑外伤并脑积水的疗效确切，预后良好，安全性高，值得临床推广使用。 【关键词】脑外伤；脑积水；颅骨修补；脑室-腹腔分流 Efficacy of early cranial repair combined with ventriculo-peritoneal shunt in patients with brain trauma and hydrocephalus [Abstract] Objective：To analyze the curative effect of early skull repair combined with ventricle-peritoneal shunt in patients with brain trauma and hydrocephalus. Methods：The clinical data of 86 patients with brain trauma and hydrocephalus were retrospectively analyzed. According to the time of skull repair，41 patients in the control group were treated with intraventricular-peritoneal shunt. After 2 months，the skull was repaired. 45 cases were treated with early（2 months）skull repair combined with ventriculo-peritoneal shunt. The operative treatment，curative effect and prognosis were compared between the two groups. Results：The operation time and flap dissociation time of the observation group were shorter than those of the control group. The incidence of complications was less than that of the control group. The difference was statistically significant（Plt;0.05）. After operation，the GCS score，ADL score，and Fugl-Meyer score of the observation group were significantly higher than those of the control group，the difference was statistically significant（Plt;0.05）. Conclusion：Early cranial repair combined with ventricle - peritoneal shunt is effective in the treatment of brain trauma and hydrocephalus. It has a good prognosis and high safety. It is worthy to be popularized in clinical practice. Key words：traumatic brain injury；hydrocephalus；skull repair；ventricle-peritoneal shunt 颅脑外伤是指在外力强烈