颅脑外伤后并发脑积水34例临床诊治分析

Clinical analysis of 34 cases after traumatic brain injury complicated with hydrocephalus

目的探讨颅脑外伤后并发脑积水的诊断与治疗方法。方法对34例颅脑外伤后并发脑积水患者的临床资料进行回顾性分析，包括临床表现、影像学检查结果、治疗方法、临床疗效等，将所得数据经统计学分析后获得结论。结果34例颅脑外伤后并发脑积水患者经正确诊断及相应治疗后，GCS评分较之前有显著提高，差异有统计学意义（P〈0．05）；经颅脑CT检查可知所有患者全脑室系统较术前显著缩小，无死亡情况发生。3例患者治疗过程中发生分流管堵塞（发生率为8．82％）；随访12个月，其中1例（2．94％）患者仍存在精神功能障碍。结论临床医生应准确掌握颅脑外伤后并发脑积水的临床特征，对疑似病例积极给予各项检查确诊病情，提供正确有效的临床治疗措施，保障患者的生活质量及生命安全。

Objective To investigate the diagnosis and treatment of concurrency hydrocephalus after traumatic brain injury. Methods The clinical data of 34 patients with traumatic brain injury complicated with hydrocephalus were retrospectively analyzed, including clinical presentation, imaging findings, treatment, clinical efficacy, etc, and the resulting data were analyzed statistically after obtaining conclusions. Results The 34 cases of traumatic brain injury after cerebral hydrocephalus patients improved significantly after than before the correct diagnosis and appropriate treatment, GCS score, compared the results, there were significant differences （P 〈 0.05 ） ; by brain CT examination found that all patients compared with the whole of the ventricular system preoperative significantly reduced, no death occurred. Three patients shunt blockage occurs during abnormal conditions （the incidence was 8.82% ） ; effective follow-up of 12 months, including 1 case （2.94%） patients still exist mental dysfunction. Conclusions Clinicians should accurately grasp the clinical features of traumatic brain injury complicated by hydrocephalus, given the positive suspected cases diagnosed illness, provide correct and effective clinical treatment, protect quality of life and the lives and safety of patients.