脑室腹腔分流联合颅骨缺损修补术治疗颅骨缺损合并脑积水的疗效分析

Analysis of the Clinical Effect of Cranioplasty and Ventriculoperitoneal Shunt at Same or Elective Stage for Skull Defect and Hydrocephalus

目的:探讨颅骨缺损合并脑积水应用脑室腹腔分流同期或择期联合颅骨缺损修补术治疗的临床效果及安全性。方法:选取2014年1月至2016年3月收治的颅骨缺损合并脑积水患者86例为研究对象,采用随机数字表法分为观察组与对照组,每组43例,观察组行脑室腹腔分流同期联合颅骨缺损修补术,对照组在脑室腹腔分流术后择期实施颅骨缺损修补术,观察2组患者治疗效果,神经功能恢复情况及并发症发生率。结果:观察组与对照组治疗总有效率分别为93.02%、76.74%,差异有统计学意义(P<0.05);术后1个月、3个月观察组NIHSS评分均显著低于对照组(P<0.01);观察组与对照组术后并发症发生率分别为11.63%、30.23%,差异有统计学意义(P<0.05)。结论:同期实施脑室腹腔分流联合颅骨缺损修补术,疗效确切,可明显改善神经功能,减少并发症发生,值得推广。

Objective： To explore the clinical effect and security of cranioplasty and ventriculoperitoneal shunt at same or elective stage for skull defect and hydrocephalus. Methods： A total of 86 patients with skull defect and hydrocephalus from Jan 2014 to Mar 2016 were randomly divided into observation group and control group of 43 cases respectively. The observation group was treated by cranioplasty and ventriculoperitoneal shunt at same stage, while the control group was treated by cranioplasty and ventriculoperitoneal shunt at elective stage. Therapeutic effect, nerve functional restoration and complication rates in the two groups were observed. Results： The total effective rate in the observation group （93.02%） was significantly higher than that in the control group （76.74%） （P〈0.05） . Compared with the nerve function damage degree before treatment of two groups, no significant difference was found （P〉0.05） . The NIHSS at 1 month or 3 months after operation in the observation group were both significantly higher than that in the control group （P〈0.01） . The postoperative complication rate in the observation group （11.63%） was significantly lower than that in the control group （30.23%） （P〈0.05） . Conclusion： Cranioplasty and ventriculoperitoneal shunt carried out at same stage can effectively improve neurological function and reduce the postoperative complication rate, which is worth wide application.