早期颅骨修补术与脑室腹腔分流术治疗脑外伤临床效果比较

Comparison of the effect of cranioplasty and ventriculoperitoneal shunt in the treatment of traumatic brain injury

目的 探讨临床中早期颅骨修补术和脑室腹腔分流术治疗脑外伤的临床效果.方法 将70例脑外伤开颅去骨瓣减压术后并脑积水患者采用数字表法随机分为两组,对照组35例先行脑室腹腔分流术,并在术后3～6个月行颅骨修补术治疗；研究组35例在术后2～3个月一次同时行早期颅骨修补术与脑室腹腔分流术治疗.观察两组的临床治疗效果.结果 研究组术后GCS优良率（71.4％）显著高于对照组（57.2％）（x2 =7.47,P＜0.05）,良好率显著高于对照组（x2=8.35,P＜0.05）,中残率显著低于对照组（x2 =7.33,P＜0.05）,并发症发生率（14.3％）显著低于对照组（34.3％） （x2 =7.35,P＜0.05）.结论 对脑外伤患者采取早期行颅骨修补术与脑室腹腔分流术治疗能够有效促进患者康复,并且降低术后并发症.

Objective To investigate the clinical effects of early cranioplasty and ventriculoperitoneal shunt in the treatment of traumatic brain injury.Methods 70 patients with traumatic brain injury were randomly divided into two groups.35 cases in the control group were treated with ventriculoperitoneal shunt,and received cranioplasty postoperative 3-6 months.35 patients in study group received early cranioplasty and ventriculoperitoneal shunt in 2-3 months after treatment.The therapeutic effects of the two groups were observed.Results After GCS,the excellent and good rate of study group was 71.4%,which was significantly higher than 57.2% of the control group （x2 =7.47,P 〈 0.05）.The good rate of the study group was significantly higher than that of the control group （x2 =8.35,P 〈0.05）.The moderate disability rate of the study group was significantly lower than that of the control group （x2 =7.33,P 〈0.05）.The incidence rate of complications in the study group was 14.3%,which was significantly lower than 34.3% in the control group （x2 =7.35,P 〈 0.05）.Conclusion Early cranioplasty and ventriculoperitoneal shunt therapy in the treatment of patients with traumatic brain injury can effectively improve clinical recovery of the patients,and reduce the postoperative complications.