去骨瓣减压术后早期颅骨修补联合脑室腹腔分流术的疗效分析

Therapeutic efficacy of early cranioplasty combined with ventriculo-peritoneal shunt in patients after decompressive craniectomy

目的:探讨去骨瓣减压术后并发脑积水患者早期联合行颅骨修补和脑室-腹腔分流术对患者预后的改善情况。方法:将51例去骨瓣减压术后并发脑积水患者分为两组,对照组先行脑室-腹腔分流术,待4～6个月后再行人工颅骨修补术,治疗组在去骨瓣减压术后2～3个月同时完成脑室-腹腔分流和人工颅骨修补术。比较两种手术方式患者远期恢复情况。结果:对照组恢复良好4例,中度残疾5例,重度残疾7例,植物生存5例,死亡1例。治疗组恢复良好12例,中度残疾10例,重度残疾6例,植物生存1例,无死亡病例。结论:对去骨瓣减压术后并发脑积水的患者早期行颅骨修补联合脑室-腹腔分流术可促进神经功能的恢复,提高患者生活质量,有助于患者预后的改善。

Objective To investigate the therapeutic eificacy of early cranioplasty combined ventriculo - peritoneal shunt on the progno- sis in patients received decompressive craniectomy with hydrocephalus. Method 51 cases of the decompressive craniectomy with hydro- cephalus were divided into two groups. The control group received ventrieulo - peritoneal shunt first after deeompressive craniectomy and then received cranioplasty 4 - 6 months later, the treatment group received ventriculo - peritoneal shunt and cranioplasty together after de- compressive cranieetomy 2 - 3 months later. The long - term recovery effect was compared between the two groups. Results In the control group,well recovery was 4 cases, moderate disability was 5 cases, severe disability was 7 cases, vegetative state was 5 cases, death was 1 case. In the treatment group ,well recovery was 12 cases ,moderate disability was 10 cases, severe disability was 6 cases ,vegetative state was 1 case, and without death. Conclusion Early cranioplasty combined ventriculo - peritoneal shunt could be a effectual approach to promote the recovery of neural function,improve quality of life, contribute to the improvement of the prognosis in patients with decompressive crani- ectomy combined with hydrocephalus.