脑室-心房分流术治疗重型颅脑外伤合并脑积水

Ventricle-right atrium shunt for the treatment of the hydrocephalus after severe brain injury

目的 提高重型颅脑外伤的治疗水平。 方法 32例重型颅脑外伤首次行开颅血肿清除、内减压、去骨辨减压术治疗后 ,症状改善不明显。术后 1～ 6周内头 CT复查证实合并脑积水、颅内压增高 ,及时行脑室 -心房分流术。 结果 大部分患者症状均明显改善。 GCS较分流前明显提高 (P<0 .0 5 )。 结论 重型颅脑外伤首次术后 ,虽经积极治疗 ,症状无明显改善者 ,应尽早复查头颅 CT,如合并脑积水 ,尽早行分流手术 ,以改善神经功能。

Objective To improve the treatment outcome of severe brain injury. Methods 32 cases of severe brain injury had no significant recovery after first emergency operation. Hydrocephalus showed by CT scans had come about in these patients during the period of postoperation. All of the patients were given a timely vetricle to right artrium shunt. Results Most of patients had a significant recovery in clinical findings. GCS had been improved much higher than those of preshunt( P <0.05). Conclusion Patients with severe brain injury may have hydrocephalus and should be examined by head CT as early as possible, if they have no significant recovery after first opration. It is very necessary for these patients to be given a shunt in order to improve their nervous functions.