早期脑室腹腔分流术与颅骨修补术治疗老年脑外伤患者的临床效果

Clinical Effect of Early Ventricular-abdominal Shunt and Skull Repair in the Treatment of Elderly Patients with Traumatic Brain Injury

目的:研究早期脑室腹腔分流术与颅骨修补术治疗老年脑外伤患者的临床效果与对认知功能、应激反应的影响。方法:通过回顾性分析的方式,选取2018年1月-2020年6月本院收治的120例老年脑外伤患者为研究对象,根据治疗方法对120例患者进行分组处理(对照组、观察组),每组60例。对照组于患者开颅血肿清除术后3个月行脑室腹腔分流术,并于脑室腹腔分流术3~6个月后再行颅骨修补术;观察组于患者开颅血肿清除术后3个月,行早期脑室腹腔分流与颅骨修补术同时进行。分别对两组治疗总有效率、治疗前后的认知功能、应激反应指标及术后并发症发生率进行比较。结果:观察组治疗总有效率明显高于对照组,差异有统计学意义(P<0.05);治疗后观察组FIM评分和MMSE评分明显高于对照组,差异有统计学意义(P<0.05);治疗后两组Cor、IL-6、TNF-α指标水平均有上升,但观察组的Cor、IL-6、TNF-α水平均低于对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。结论:通过早期脑室腹腔分流术与颅骨修补术联合对老年脑外伤患者进行治疗,不仅能够改善患者的认知功能和应激反应,还能降低患者的术后并发症发生率,治疗效果较为显著。

Objective:To study the clinical effect of early ventricular-abdominal shunt and skull repair in the treatment of elderly patients with traumatic brain injury and their influence on cognitive function and stress response.Method:Through retrospective analysis,120 elderly patients with traumatic brain injury admitted to our hospital from January 2018 to June 2020 were selected as the research objects,and 120 patients were divided into the control group and the observation group according to treatment methods.60 cases in each group.Patients in the control group underwent ventricular-abdominal shunt 3 months after craniotomy and hematoma removal,and 3-6 months after ventricular-abdominal shunt surgery,and then underwent skull repair;Patients in the observation group,3 months after craniotomy and hematoma removal,the early ventricular-abdominal shunt was performed simultaneously with skull repair.The total effective rate of treatment,cognitive function before and after treatment,stress response indicators and postoperative complications were compared between the two groups of patients.Result:The total effective rate of treatment in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the FIM score and MMSE score of the observation group were significantly higher than those of the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of Cor,IL-6 and TNF-αin the two groups of patients increased,but the levels of Cor,IL-6 and TNF-αin the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the control group,and the differences were statistically significant(P<0.05).Conclusion:The combination of early ventricular-abdominal shunt and skull repair can not only improve the cognitive function and stress response of patients,but also reduce the incidence of postoperative complications,and the treatment effect is more significant.