早期脑室——腹腔分流术同期联合颅骨修补术治疗脑外伤伴脑积水的临床探讨

Clinical Study of early ventriculoperitoneal Shunt combined with Cranioplasty in the Treatment of Traumatic Brain Injury with Hydrocephalus

目的探讨早期脑室—腹腔分流术同期联合颅骨修补术治疗脑外伤伴脑积水的临床效果。方法选取郑州市第二人民医院2018年10月至2019年10月收治的82例脑外伤伴脑积水患者作为研究对象,按不同的手术治疗方案将其分为A组与B组,每组41例。A组同期行早期脑室—腹腔分流术联合颅骨修补术;B组先行早期脑室—腹腔分流术治疗,之后择期行颅骨修补术;比较两组患者日常生活能力(ADL评分)、四肢运动功能(Fugl-Meyer评分)及预后情况。结果治疗前,两组的ADL、Fugl-Meyer评分对比无统计学意义(P>0.05);治疗后,两组的ADL、Fugl-Meyer评分较治疗前均显著提高(P<0.05),且A组的ADL、Fugl-Meyer评分均高于B组(P<0.05)。A组良好率(60.98%)高于B组(39.02%)(P<0.05)。结论早期脑室—腹腔分流术同期联合颅骨修补术治疗脑外伤伴脑积水患者,能更好地改善患者日常生活能力与四肢运功功能,利于患者预后。

Objective To investigate the clinical effect of early ventriculoperitoneal shunt combined with cranioplasty in the treatment of hydrocephalus after traumatic brain injury.Methods From October 2018 to October 2019,82 patients with traumatic brain injury and hydrocephalus in the second people’s Hospital of Zhengzhou were selected as study subjects.Group A was treated with early ventriculoperitoneal shunt combined with Cranioplasty simultaneously,group B was treated with early ventriculoperitoneal shunt before cranioplasty.The activities of daily living(ADL),limb motor function(Fugl-Meyer)and prognosis were compared between the two groups.Results Before treatment,the scores of ADL and Fugl-Meyer in the two groups were not statistically significant(P>0.05),after treatment,the scores of ADL and Fugl-Meyer in the two groups were significantly higher than those before treatment(P<0.05),and the scores of ADL and Fugl-Meyer in group A were higher than those in group B(P<0.05).The good rate in group A(60.98%)was higher than that in group B(39.02%)(P<0.05).Conclusion early ventriculoperitoneal shunt combined with cranioplasty can improve the ability of daily living and function of limbs in patients with traumatic brain injury and hydrocephalus.