用脑室-腹腔分流及颅骨修补术治疗脑外伤并发脑积水伴颅骨缺损的时机分析

Analysis of Opportunities of Ventriculoperitoneal Shunt and Cranioplasty in Treatment of Cerebral Trauma, Hydrocephalus Combined with Skull Defect

目的为了提高脑室-腹腔分流及颅骨修补术治疗脑外伤并发脑积水伴颅骨缺损的治疗效果,分析治疗时机的选择。方法根据随机原则的相关要求从2016年7月—2017年7月在该院通过脑室-腹腔分流及颅骨修补术治疗脑外伤并发脑积水伴颅骨缺损的患者中挑选100例作为研究对象并借助计算机软件将其分组,其中接受脑室-腹腔分流术及颅骨修补术同期治疗的设为观察组,接受脑室-腹腔分流术及颅骨修补术分期治疗的设为对照组,比较不同治疗方案对疗效以及格拉斯哥预后评分(GOS)、格拉斯哥昏迷评分(GCS)的影响。结果研究表明,观察组和对照组患者治疗后并发症发生率分别为4例(8.00%)和24例(48.00%),组间比较差异有统计学意义(χ~2=8.43,P<0.05);治疗后观察组和对照组患者的GOS评分分别为(4.29±0.88)分、(3.53±0.60)分,GCS评分分别为(13.02±1.88)分、(10.28±1.08)分,组间比较差异有统计学意义(tGOS=6.32,t GCS=5.88,P<0.05)。结论用脑室-腹腔分流及颅骨修补术治疗脑外伤并发脑积水伴颅骨缺损的患者,不仅可以提高治疗的总有效率,而且还能够预防和减少各种并发症的发生,效果确切,值得临床应用。

Objective To improve the treatment effect of ventriculoperitoneal shunt and cranioplasty in treatment of cerebral trauma, hydrocephalus combined with skull defect and analyze the selection of treatment opportunities. Methods 100 cases of patients with cerebral trauma, hydrocephalus combined with skull defect admitted and treated in our hospital from July 2016 to July 2017 were randomly selected and randomly divided into two groups, the observation group were treated with ventriculo-peritoneal shunt and skull repair concurrent therapy, while the control group were treated with ventriculo-peritoneal shunt and skull repair staging therapy, and the curative effect, GOS and GCS were compared among different treatment plans. Results The research showed that the incidence rate of complications after treatment in the observation group and in the control group was respectively 4 cases（8.00%）,24 cases（48.00%）, and the difference between groups was statistically significant（χ^2=8.43, P 〈0.05）, after treatment, the GOS score and the GCS score in the observation group and in the control group were respectively（4.29 ±0.88）points,（3.53 ±0.60）points and（13.02±1.88）points,（10.28±1.08）points, and the differences between groups were statistically significant（t GOS =6.32,t GCS=5.88, P 〈0.05）. Conclusion The ventriculoperitoneal shunt and cranioplasty in treatment of cerebral trauma, hydrocephalus combined with skull defect can not only improve the total treatment effective rate, but also prevent and reduce the occurrence of various complications, and the effect is definite, and it is worth clinical application.