脑室-腹腔分流术联合颅骨修补术同期治疗脑积水的效果

The Effect of Ventricular-abdominal Shunt Combined with Cranioplasty in the Treatment of Hydrocephalus at the Same Period

目的探讨脑室-腹腔分流术联合颅骨修补术同期治疗脑积水的效果。方法选取2016年6月—2020年6月期间该院收治的104例脑积水患者作为研究对象,根据数字表法随机分为对照组(n=52)和观察组(n=52),对照组在脑室-腹腔分流术后择期开展颅骨修补术治疗,观察组同期开展脑室-腹腔分流术和颅骨修补术治疗,比较两组患者治疗前后Barthel日常生活活动能力量表(BI指数)评分、Fugl-Meyer四肢感觉功能量表(FMA)评分、蒙特利尔认知评估量表(MoCA)评分以及卡氏功能状态评分量表(KPS)评分,以及两组患者临床治疗总有效率。结果治疗前观察组BI评分(35.12±2.13)分,FMA评分(48.52±2.24)分,MoCA评分(17.86±1.58)分,KPS评分(60.41±2.26)分,对照组BI评分(35.18±2.16)分,FMA评分(48.56±2.31)分,MoCA评分(17.84±1.62)分,KPS评分(60.47±2.32)分,差异无统计学意义(t=0.143、0.089、0.064、0.134,P>0.05);治疗后观察组BI评分(73.22±3.48)分,FMA评分(76.85±3.56)分,MoCA评分(26.47±2.15)分,KPS评分(73.35±3.61)分,对照组BI评分(65.36±2.35)分,FMA评分(65.47±3.23)分,MoCA评分(22.32±2.06)分,KPS评分(67.77±2.24)分,差异有统计学意义(t=13.515、17.072、10.050、9.471,P<0.05)。观察组临床治疗总有效率为94.23%,高于对照组的76.92%,差异有统计学意义(χ^(2)=6.310,P<0.05)。结论脑室-腹腔分流术联合颅骨修补术同期治疗脑积水效果确切,对患者生活能力、运动能力和认知功能改善更理想,因此可用于临床推广。

Objective To investigate the effect of ventricular-abdominal shunt combined with cranioplasty in the treatment of hydrocephalus at the same time.Methods 104 cases of hydrocephalus patients admitted to the hospital from June 2016 to June 2020 were selected as the research objects,and were randomly divided into a control group(n=52)and an observation group(n=52)according to the number table method.The control group received elective cranioplasty after ventricular-abdominal shunt surgery,and the observation group received ventricular-abdominal shunt and cranioplasty treatment at the same time.The Barthel activities of daily living(BI index)scores,Fugl-Meyer Limb Sensory Function Scale(FMA)scores,Montreal Cognitive Assessment Scale(MoCA)scores,and Karnofsky functional status scale(KPS)scores,as well as the total effective rate of clinical treatment of the two groups of patients.Results Before treatment,the observation group had BI score(35.12±2.13)points,FMA score(48.52±2.24)points,MoCA score(17.86±1.58)points,KPS score(60.41±2.26)points,and control group BI score(35.18±2.16)points,FMA score(48.56±2.31)points,MoCA score(17.84±1.62)points,KPS score(60.47±2.32)points,the difference was not statistically significant(t=0.143,0.089,0.064,0.134,P>0.05);BI score(73.22±3.48)points,FMA score(76.85±3.56)points,MoCA score(26.47±2.15)points,KPS score(73.35±3.61)points of observation group,BI score(65.36±2.35)points,FMA score(65.47±3.23)points,MoCA score(22.32±2.06)points,KPS score(67.77±2.24)points of control group,the difference was statistically significant(t=13.515,17.072,10.050,9.471,P<0.05).The total effective rate of clinical treatment in the observation group was 94.23%,which was higher than 76.92%in the control group.The difference was statistically significant(χ^(2)=6.310,P<0.05).Conclusion The ventricle-abdominal shunt combined with cranioplasty is effective in treating hydrocephalus at the same time,and it is more ideal for the improvement of patients'living ability,exercise ability and cognitive function,so it can be used for clinical promotion.