外伤性脑积水脑室-腹腔分流的临床观察

Clinical observation of ventriculoperitoneal shunt for traumatic hydrocephalus

目的评价脑室-腹腔(V-P)分流对创伤性脑损伤后不同程度的脑积水的治疗效果。方法根据CT影像显示脑室大小,将创伤性脑损伤后脑积水患者50例分为轻度(19例),中度(17例),重度(14例)三组,行V-P分流手术治疗,比较手术前后脑室径与双顶径的比值(V/BP),室周水肿带直径及GOS评分。结果分流三个月后轻中度脑积水组三项指标均显著优于术前(P<0.05),重度脑积水组与术前相比,差异无显著性意义(P>0.05)。结论轻中度外伤性脑积水V-P分流效果较好,重度脑积水患者分流手术后恢复欠佳,临床上对外伤性脑积水患者应尽早发现、及时治疗。

Objective To investigate the effect of venlriculoperitoneal shunt （V-P） for the treatment of post-traumatic hydrocephalus. Methods According to the swelling size of cerebral ventricle on CT images, 50 patients （29 males, 21 females, 15-68 years old） with post-traumatic hydrocephalus were divided into 3 groups： mild, moderate and severe groups. They underwent V-P shunt during 2000-2005. The sizes of cerebral ventricle, degrees of hydrocephalus and GOS scores before and after operation were compared and analyzed statistically. Results Three months after operation, the 3 indexes of mild and moderate groups were superior significantly to those before operation （P〈0.05）, while the severe group did not have obvious changes （P〉0.05）. Conclusion The curative effect of V-P shunt is better for the mild and moderate traumatic hydrocephalus than for the severe ones. So early diagnosis and prompt treatment are essential for a good prognosis.