侧脑室-腹腔分流术在改善脑外伤后脑积水患者日常生活能力的作用

Effect of V-P shunt on the daily life of patients with hydrocephalus

目的探讨侧脑室-腹腔(ventriculo-peritoneal,V-P)分流术在改善脑外伤后脑积水患者日常生活能力的作用。方法选取151例行V-P分流术的脑积水患者,其中昏迷患者112例,清醒患者39例。昏迷患者行V-P分流术前及术后6个月行格拉斯哥昏迷(glasgow coma scale,GCS)评分及日常生活能力评定(Barthel指数),清醒患者术前及术后6个月行Barthel指数评定。结果 112例昏迷患者术前GCS为(7.00±1.96)分,术后6个月为(9.50±3.30)分,两者比较差异具有统计学意义(P<0.05);术前Barthel指数为(0.00±0.00)分,术后6个月为(15.24±21.92)分,两者比较差异有统计学意义(P<0.05)。39例清醒患者术前Barthel指数为(55.56±34.77)分,术后6个月为(63.89±34.98)分,两者相比差异无统计学意义(P>0.05)。结论 V-P分流术可改善脑外伤后昏迷的脑积水患者的GCS评分及日常生活能力,但对清醒患者的日常生活能力改善不明显。

Objective To study the effeet of V - P shunt on the daily life of patients with hydrocephalus. Methods 151 patients with hydrocephalus who received V - P shunt were observed, 112 of whom were in coma and 39 were conscious . Among the comatose patients, Glasgow Coma Scale（GCS） and Barthel index were evaluated before and six months after V -P shunt. For the conscious patients, only Barthel index was evaluated before and six months after V - P shunt. Results GCS of patients in coma before V -P shunt was （7.00 ± 1.96） and （9.50 ± 3.30） six months later. The score was significantly improved （P 〈 0.05 ）. The Barthel index in patients in coma hefore and six months after V - P shunt was （0. 00 ± 0.00） and （ 15. 24 ± 21.92） respectively. The score was also significantly improved （ P 〈 0.05 ）. Barthel index of conscious patients was （ 55.56 ± 34.77 ） before V - P shunt and （63.89 ± 34.98） six months after V - P shunt. It was not siginificantly improved（P 〉 0.05）. Conclusions V - P shunt improves GCS and daily activities of comatose patients with hydrocephalus ,but has little effect on conscious patients.