不同时期颅骨缺损修补术对脑外伤开颅术后并发脑积水患者神经功能及预后的影响

Effects of skull defect repair at different stages on neurological function and prognosis of patients complicated with hydrocephalus after craniotomy

目的探究不同时期颅骨缺损修补术对脑外伤开颅术后并发脑积水患者神经功能及预后的影响。方法选择2017年8月—2021年8月本院收治的64例脑外伤开颅术后并发脑积水患者作为研究对象,按照颅骨修补时期的不同分为观察组和对照组两组,每组各32例。对照组采用颅骨缺损修补术在脑室腹腔分流术后3个月,观察组采用颅骨缺损修补术与脑室腹腔分流术同期。比较两组患者预后情况、神经功能采用美国国立卫生院卒中量表(NIHSS)评估及并发症总发生率。结果观察组患者预后良好发生率(90.63%)高于对照组(56.25%),差异有统计学意义(P<0.05);手术前,两组患者NIHSS评分比较,差异无统计学意义(P>0.05);手术后,两组患者NIHSS评分较手术前均显著低于手术前,且观察组患者NIHSS评分低于对照组,差异有统计学意义(P<0.05);观察组患者并发症发生率(9.38%)低于对照组(34.38%),差异有统计学意义(P<0.05)。结论早期颅骨缺损修补术应用于脑外伤开颅术后并发脑积水患者,可以改善预后,提高疗效,改善患者神经功能,降低并发症发生率。

Objective To explore the effect of skull defect repair in different stages on neurological function and prognosis of patients complicated with hydrocephalus after craniotomy.Methods 64 patients complicated with hydrocephalus after craniotomy due to cerebral trauma in our hospital from August 2017 to August 2021 were selected as the research objects.According to the different periods of skull repair,they were divided into control group(skull defect repair 3 months after ventriculoperitoneal shunt)and observation group(skull defect repair and ventriculoperitoneal shunt at the same time),with 32 cases in each group.The prognosis,neurological function(was evaluated by using National Institutes of Health Stroke Scale,NIHSS)and the total incidence of complications were compared between the two groups.Results The incidence of good prognosis in the observation group was 90.63%,which higher than that in the control group(56.25%),there was significant difference between the two groups(P<0.05).There was no significant difference in NIHSS score between 2 groups before surgery(P>0.05).The NIHSS scores of the two groups after operation were lower than those before operation(P<0.05),and the NIHSS scores of the observation group were lower than those of the control group(P<0.05).The incidence of complications in the observation group(9.38%)was lower than that in the control group(34.38%),there was significant difference between the two groups(P<0.05).Conclusions Early skull defect repair applied to patients complicated with hydrocephalus after craniotomy could improve prognosis,improve efficacy,improve neurological function and reduce the incidence of complications.