早期颅骨修补与脑室腹腔分流对脑外伤患者的疗效观察

目的比较不同手术时期颅骨修补与脑室腹腔分流手术对于脑外伤患者的临床治疗效果。方法将64例颅脑外伤患者随机分为试验组和对照组,试验组患者在开颅血肿清除术后3个月左右同时行早期颅骨修补与脑室腹腔分流术,对照组患者先行脑室腹腔分流术,3～6个月后再行颅骨修补术。比较两组患者治疗前后的GCS评分、术后并发症发生情况及远期预后情况。结果两组患者治疗后GCS评分均显著升高(P<0.05),试验组术后GCS评分显著高于对照组。试验组预后良好率及存活率显著高于对照组(P<0.05)。而并发症的发生率无显著差异(P>0.05)。结论对于脑积水合并颅骨缺损的脑外伤患者,应行早期颅骨修补及脑室腹腔分流术,能显著降低患者的病死率,值得临床进一步推广。

Objective To compare clinical effect of cranioplasty and ventriculoperitoneal shunt surgery for patients with traumatic brain injury on different surgical period. Methods 64 patients with traumatic brain injury in our hospital were randomly divided into the experimental group and the control group. The experimental group patients were given early cranioplasty and ventriculo-peritoneal shunt at the same time 3 months after hematoma evacuation,while the control group patients were given ventricle peritoneal shunt first and the line cranioplasty after 3 to 6 months. GCS score, the incidence of postoperative complications and long-term prognosis of the two groups were compared. Results After treatment, the GCS score was significantly higher （P〈0.05）, postoperative GCS of the experimental group score was significantly higher than the control group. The good prognosis rate and survival rate of the experimental group was significantly higher than those of the control group （P〈0.05）. There was no significant difference in incidence of complications （P〉 0.05）. Conclusion Early cranioplasty and ventriculo-peritoneal shunt for hydrocephalus merger skull defects in patients with traumatic brain injury can significantly reduce the mortality of patients, which is worthy of further promotion.