不同时间行脑室-腹腔分流术及颅骨修补术在颅脑损伤减压术后交通性脑积水患者中的临床疗效

Clinical efficacy of ventriculo-peritoneal shunt and cranioplasty surgery at different times in patients with communicating hydrocephalus after craniocerebral injury decompression

目的研究不同时间行脑室-腹腔(V-P)分流术及颅骨修补(CP)术在颅脑损伤减压术后交通性脑积水患者中的临床疗效。方法选取我院2017年3月至2020年5月收治的82例颅脑损伤减压术后出现交通性脑积水患者作为研究对象,根据手术方案不同将其分为对照组和观察组,各41例。对照组首先进行V-P分流术,3~5周后再进行CP术;观察组首先进行CP术,3~5周后再进行V-P分流术。比较两组的治疗效果。结果观察组的治疗总有效率高于对照组(P<0.05)。术后1、6个月,观察组的格拉斯哥昏迷量表(GCS)、格拉斯哥预后量表(GOS)评分明显高于对照组(P<0.05)。观察组的术后并发症总发生率低于对照组(P<0.05)。结论尽早先行CP术后行V-P分流术可避免术后感染和出血等其他并发症发生,可有效改善手术预后情况,临床应用效果显著。

Objective To study the clinical efficacy of ventriculo-peritoneal(V-P)shunt and cranioplasty(CP)surgery at different times in patients with communicating hydrocephalus after craniocerebral injury decompression.Methods A total of 82 patients with communicating hydrocephalus after craniocerebral injury decompression admitted in our hospital from March 2017 to May 2020 were selected as the research objects.According to different surgical schemes,the patients were divided into control group and observation group,with 41 cases in each group.In the control group,V-P shunt was performed first,and CP surgery was performed 3-5 weeks later;in the observation group,CP surgery was first performed,and V-P shunt was performed 3-5 weeks later.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).At 1 and 6 months after operation,the scores of Glasgow Coma Scale(GCS)and Glasgow Outcome Scale(GOS)in the observation group were significantly higher than those in the control group(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).Conclusion Early CP surgery followed by V-P shunt can avoid other complications such as postoperative infection and bleeding,effectively improve the prognosis of surgery,and the clinical application effect is significant.