脑外伤并发脑积水患者应用脑室-腹腔分流手术治疗的效果研究

Research on Effect of Ventriculoperitoneal Shunt Surgery in Treatment of Patients with Brain Trauma Combined with Hydrocephalus

目的分析脑外伤并发脑积水患者应用脑室-腹腔分流手术治疗的效果。方法随机选取该院2014年2月—2017年5月期间收治的56例脑外伤并发脑积水患者,根据脑积水严重程度,分为2组,一组为轻中度组(37例),一组为重度组(19例),2组患者均行脑室-腹腔分流手术,观察并比较临床疗效。结果比较临床疗效,轻中度组21例显效,14例有效,2例无效,总有效率为94.5%(35/37),重度组8例显效,6例有效,5例无效,总有效率为73.6%(14/19),比较2组结果,通过数据分析显示,差异有统计学意义(χ~2=16.291,P=0.000)。比较GCS评分、V/BP值和脑室周围水肿带直径,轻中度组术前与术后3个月差异有统计学意义(t=4.060、15.102、4.838,P<0.05),改善明显,而重度组,有所改善,但术后3个月与术前比较差异无统计学意义(t=0.706、1.328、0.602,P>0.05)。结论脑外伤并发脑积水,实施脑室-腹腔分流手术,疗效显著,有效改善临床症状。相比重度脑积水,轻中度脑积水疗效更明显,因此,尽早治疗脑外伤合并脑积水,对改善预后效果,具有积极意义。

Objective To analyze the effect of ventriculoperitoneal shunt surgery in treatment of patients with brain trauma combined with hydrocephalus. Methods 56 cases of patients with brain trauma combined with hydrocephalus admitted and treated in our hospital from February 2014 to May 2017 were randomly selected and divided into two groups, including the mild and middle group with 37 cases, and severe group with 19 cases, and both groups were treated with brain trauma combined with hydrocephalus, and the clinical curative effect was observed and compared.Results In terms of clinical curative effect, in the mild and middle group, 21 cases were markedly effective, 14 cases were effective, and 2 cases were ineffective, and the total effective rate was 94.5%（35/37）, in the severe group, 8 cases were markedly effective, 6 cases were effective and 5 cases were ineffective, and the total effective rate was 73.6%（14/19）, and the results were compared between the two groups, and the data analysis showed that the difference was obvious, with statistical significance（χ~2=16.291,P=0.000）, and the differences in the GCS score, V/BP value and periventricular edematous diameter in the mild and middle group before surgery and in three months after surgery were obvious, with statistical significance（t=4.060,15.102,4.838,P〈0.05）, and the improvement was obvious, and the differences in the severe group before surgery and in three months after surgery were not obvious（t=0.706,1.328,0.602,P〈0.05）.Conclusion The curative effect of ventriculoperitoneal shunt surgery in treatment of patients with brain trauma combined with hydrocephalus is obvious, which can effectively improve the clinical symptoms, and the curative effect of hydrocephalus in the mild and middle group is more obvious than that in the severe group, therefore, we should treat the brain trauma combined with hydrocephalus as early as possible, which is of positive significance to improving the prognosis effect.