颅脑损伤同期行颅骨修补及脑室腹腔分流术治疗的效果研究

Study on the effect of simultaneous skull repair and ventriculoperitoneal shunt in the treatment of craniocerebral injury

目的观察颅脑损伤同期行颅骨修补及脑室腹腔分流术治疗的效果。方法86例颅脑损伤患者,按照手术方法不同分为对照组和实验组,每组43例。对照组患者先行脑室腹腔分流术,3个月后行颅骨修补术;实验组患者同期行颅骨修补及脑室腹腔分流术。比较两组患者手术前后炎症因子、氧化指标、神经功能、生活质量及治疗效果、术后并发症发生情况、治疗满意度。结果术后1周,实验组患者C反应蛋白(45.82±4.28)mg/L、白细胞介素-6(32.58±4.11)ng/L均低于对照组的(71.15±4.19)mg/L、(60.54±4.15)ng/L,差异具有统计学意义(P<0.05)。术后1周,实验组患者一氧化氮(5.21±1.13)μmol/L、内皮素-1(61.58±4.54)pg/ml均低于对照组的(8.15±1.15)μmol/L、(80.67±4.51)pg/ml,差异具有统计学意义(P<0.05)。实验组患者治疗优良率97.67%高于对照组的86.05%,术后并发症发生率4.65%低于对照组的18.60%,差异具有统计学意义(P<0.05)。术后3个月,两组患者美国国立卫生研究院卒中量表(NIHSS)评分低于本组术前,Barthel指数高于本组术前,且实验组患者NIHSS评分(10.22±2.25)分低于对照组的(16.13±2.29)分,Barthel指数(80.21±4.30)分高于对照组的(70.08±4.33)分,差异具有统计学意义(P<0.05)。实验组患者总满意率为95.35%,高于对照组的76.74%,差异具有统计学意义(P<0.05)。结论颅脑损伤患者同期行脑室腹腔分流术与颅骨修补术可提升治疗效果,有较高的临床推广价值。

Objective To observe the effect of simultaneous skull repair and ventriculoperitoneal shunt in the treatment of craniocerebral injury.Methods A total of 86 patients with craniocerebral injury were divided into control group and experimental group according to different surgical methods,with 43 cases in each group.Patients in the control group underwent ventriculoperitoneal shunt first and skull repair after 3 months;patients in the experimental group underwent simultaneous skull repair and ventriculoperitoneal shunt.Both groups were compared in terms of inflammatory factors,oxidation indexes,neurological function and quality of life before and after surgery,therapeutic effect,occurrence of postoperative complications,and treatment satisfaction.Results 1 week after surgery,the C-reactive protein of(45.82±4.28)mg/L and interleukin-6 of(32.58±4.11)ng/L in the experimental group were lower than those of(71.15±4.19)mg/L and(60.54±4.15)ng/L in the control group,and the differences were statistically significant(P<0.05).1 week after surgery,the nitric oxide of(5.21±1.13)μmol/L and endothelin-1 of(61.58±4.54)pg/ml in the experimental group were lower than those of(8.15±1.15)μmol/L and(80.67±4.51)pg/ml in the control group,and the differences were statistically significant(P<0.05).The excellent treatment rate of 97.67%in the experimental group was higher than that of 86.05%in the control group,and the incidence of postoperative complications of 4.65%was lower than that of 18.60%in the control group.The differences were statistically significant(P<0.05).3 months after surgery,the National Institutes of Health Stroke Scale(NIHSS)score in the two groups was lower than that before surgery in this group,and the Barthel index was higher than that before surgery in this group;NIHSS score of(10.22±2.25)points in the experimental group was lower than that of(16.13±2.29)points in the control group;Barthel index of(80.21±4.30)points in the experimental group was higher than that of(70.08±4.33)points in the control group;the differences were statistically significant(P<0.05).The total satisfaction rate of the experimental group was 95.35%,which was higher than that of 76.74%of the control group,and the difference was statistically significant(P<0.05).Conclusion Simultaneous skull repair and ventriculoperitoneal shunt can improve the therapeutic effect,and has high value of clinical promotion.