早期颅骨修补术及脑室腹腔分流术治疗脑外伤的临床效果分析

目的分析早期颅骨修补术及脑室腹腔分流术(VPS)治疗脑外伤中的临床效果。方法选择2009年9月—2011年11月我院颅骨缺损并发脑积水患者60例,将其随机分为对照组和观察组,各30例。对照组先行VPS,3～6个月后再行颅骨修补术;观察组第1次手术后3个月左右行VPS及颅骨修补术。观察两组术后格拉斯哥昏迷评分(GCS)、格拉斯哥预后评分(GOS)及术后并发症情况。结果观察组术后GCS优良率、GOS恢复良好率高于对照组,术后并发症发生率低于对照组,差异均有统计学意义(P<0.05)。结论早期行颅内修补术及VPS治疗脑外伤,可提高术后恢复率、降低并发症发生率。     

脑室腹腔分流术联合不同时期颅骨修补治疗脑外伤的临床疗效比较

目的研究脑室腹腔分流术(VPS)联合不同时期颅骨修补对颅脑创伤术后颅骨缺损伴脑积水患者预后的影响。方法选取154例行颅骨修补及VPS的脑外伤患者,根据去骨瓣减压术后颅骨修补联合VPS的时间随机分为早期分流同期修补组(同期组)和早期分流延期修补组(延期组),对比分析两组患者的颅脑损伤手术后的临床效果和并发症。结果同期组患者的GOS评分、GCS评分均优于延期组(P0.05),并发症发生率低于延期组(P0.05)。结论同期行颅骨修补及VPS并发症少,可明显缓解患者意识及神经功能障碍,改善患者预后,值得临床应用推广。     

早期颅骨修补术治疗脑外伤的临床效果观察

目的:探讨早期颅骨修补术治疗脑外伤的临床效果.方法:将90例于2019年1月-2021年6月我院收治的脑外伤张患者作为研究对象,将随机数字表法作为分组方式,各45例,对照组接受脑室腹腔分流术治疗,术后6个月再接受颅骨修补术,试验组接受早期颅骨修补术治疗,对患者术前与术后的神经功能缺损(National Institut...     

脑室腹腔分流术并发症的处理

近 6年来 ,我院共对 16 4例脑积水患者施行脑室腹腔分流术 ,术后 42例发生并发症。现对此组病例进行回顾分析 ,以探讨其并发症的有效治疗方法。临床资料 :16 4例脑积水患者中 ,男 10 8例 ,女 5 6例 ;年龄 1～ 72岁 ,平均 38岁。其中梗阻性脑积水 135例 ,交通性脑积水 18例 ,脑室穿通畸形 4例 ,颅内巨大蛛网膜囊肿 3例 ,脑外脑积水 4例。所有患者均行脑室腹腔分流术治疗。术后随访7天至 6年。出现分流管堵塞 2 2例 ,感染 8例 ,过度分流 3例 ,硬膜下血肿 2例 ,腹腔并发症 7例。讨论 :分流管堵塞是脑室腹腔分流术失败的最常见原因 ,文献报道发…     

脑室-腹腔分流术术后并发症的临床分析

目的探讨脑室-腹腔分流术（VPS）术后并发症的组成及其防治措施。 方法回顾性分析厦门大学附属第一医院神经外科自2011年1月至2017年12月收治的71例行VPS的脑积水患者的临床资料,研究及分析其并发症的组成,并对未成年人和成人及分流术前颅脑有手术操作的患者与无操作的患者的并发症进行统计分析。 结果本组患者中14例（19.7%）发生并发症,其中未成年人7例（9.85%）,成人7例（9.85%）,术后并发症的发生率差异具有统计学意义（P<0.05）;术前颅脑有手术操作7例（9.85%）,颅脑无手术操作7例（9.85%）,术后并发症的发生率差异具有统计学意义（P<0.05）。 结论VPS是治疗脑积水的有效方法,但其术后并发症的发生率较高,未成年人患者和术前颅脑有手术操作的患者更易发生并发症。     

脑积水脑室-腹腔分流术后常见并发症及防治对策

目的：探讨脑积水脑室-腹腔分流术后常见并发症的原因及防治措施。方法回顾性分析2008-04～2013-01收治的脑积水脑室-腹腔分流术后并发症患者19例临床资料。结果19例中分流管阻塞7例,感染4例,硬膜下血肿或积液4例,分流管异位2例,分流管自肛门脱出1例,经治疗后患者临床症状不同程度缓解,13例患者再次行脑室-腹腔分流术,16例进行性脑积水患者复查头颅CT或MRI提示脑积水明显好转。19例患者中治愈18例,1例死于严重颅内感染,近期有效率为94.7％。结论临床应严格脑积水脑室-腹腔分流术适应证选择及无菌操作,提高手术技巧,个体化选择分流系统,对年幼患者应用可调压分流管,可减少术后并发症的发生。     

脑积水脑室-腹腔分流术后并发症及其防治

脑积水的外科治疗经历100年的实验和临床研究,已经提出的分流方法多达20余种.脑室-腹腔(V-P)分流术为目前临床首选的方法~([1]).     

腹腔镜脑室-腹腔分流术治疗脑积水156例

2000年8月-2008年8月,我们在腹腔镜下行脑室-腹腔分流术（V-P）治疗脑积水156例,疗效良好。现报告如下。     

脑室—腹腔分流术治疗正常压力脑积水疗效观察

目的观察脑室—腹腔分流术（V-P分流术）治疗正常压力脑积水的疗效。方法采用V-P分流术治疗NPH患者19例。结果本组无手术死亡,无感染、脑内血肿、堵管,发生硬膜下积液2例,慢性硬膜下血肿1例。随访6个月~2 a,显效15例,有效11例,无效4例,总有效率为83.7%。结论 V-P分流术可明显改善正常压力脑积水患者脑功能及其预后,提高其生活质量。     

脑积水82例脑室——腹腔分流术后并发症的预见性护理

目的总结脑积水行脑室——腹腔分流术的护理经验，预防术后并发症。方法对82例病人，术前给予心理护理，手术区皮肤准备，控制感染性疾病；术后密切监护意识状态，瞳孔变化，注意腹部症状和体征的观察，预防感染。结果本组病例3例发生分流管堵塞，占3.66％；4例发生颅内感染，占4.88％；5例有消化道症状，1例发生硬脑膜下血肿，全部病例10～18天痊愈出院。结论术前严格的准备。术后严密的观察护理，对可能出现的并发症给予重视，及时处理，是促使患者早日康复的重要保证。     

重型颅脑损伤患者气管切开的术后护理

目的探讨重型颅脑损伤患者气管切开手术后的护理方法。方法对我院2010年1月—2011年12月收治的56例气管切开重型颅脑损伤患者的临床资料进行回顾性分析。结果 56例气管切开重型颅脑损伤患者中临床治愈39例,6例发生肺部感染,占10.7%,5例死亡,6例自动出院。结论正确的护理方式可减少重型颅脑损伤患者气管切开的并发症,提高重型颅脑损伤的治愈率。     

臭氧治疗颅脑外伤的临床分析

目的探讨臭氧治疗颅脑外伤的疗效。方法采用臭氧对100例颅脑外伤患者进行治疗。结果臭氧治疗的总有效率达95%。结论臭氧不失为治疗颅脑外伤的一种方便、安全、有效的方法。     

Hypopituitarism and Growth Hormone Deficiency in Adult Subjects after Traumatic Brain Injury: Who and When to Test

Traumatic brain injury (TBI) was traditionally considered an infrequent cause of hypopituitarism. However recent reports strongly suggest that TBI-mediated pituitary hormones deficiency may well be more frequent than previously thought. As the prevalence of hypopituitarism is not dependent on the severity of the trauma and considering the high number of TBI events in all industrialized countries a screening procedure for detecting hormone deficiencies in all TBI patients is not possible. In the present work a suggestion for screening a subgroup of TBI patients is discussed in order to increase the effectiveness of the whole procedure.     

Placement of Gastrostomy Tubes in Patients with Ventriculoperitoneal Shunts Does Not Result in Increased Incidence of Shunt Infection or Decreased Survival

The objective of this study was to examine if G-tube (G-tube) placement in patients with ventriculoperitoneal (VP) shunts results in shunt infection or impacts patient survival. We performed a retrospective cohort study. Patients underwent VP shunt and G-tube placement. Incidence of shunt infection and patient survival were calculated. Fifty-five patients qualified for the study. Shunt infection occurred in seven patients (12.5%). The incidence of shunt infection did not differ between surgically placed G-tubes (2/7=29%) and PEG tubes (5/7=71%; P=0.69). There was no difference in the risk of VP infection based on the order of placement (OR=0.61 [0.12–3.02]; P=0.69). No predictors for shunt infection were identified. Kaplan-Meier mortality estimates demonstrated a 21% 1-year mortality rate. There were no predictors of patient survival. We conclude that placement of G-tubes in patients with shunts is safe. The order of placement of G-tube and VP shunt does not affect the incidence of shunt infection or survival.     

Brain Injury and Hypopituitarism: The Historical Background

In the year 2000, the latest review on post-head trauma hypopituitarism (PHTH) collected 367 cases of isolated or multiple deficiency of anterior pituitary hormones subsequent to traumatic brain injury. The first patient had been published in 1918 and the latest 15 were my personal observations reported in the said review. In the previous review on PHTH, which was published in 1986, a total of only 53 cases had been collected. The interest triggered by the latest review, which concluded that PHTH was indeed less rare than commonly believed, was such that a total of 192 cases have been reported from year 2000 through April, 2005.     

Human Herpes Virus 8-Negative Primary Effusion Lymphoma in a Patient With a Ventriculoperitoneal Shunt Tube

A 60-year-old woman was referred to our hospital in 1996 due to an abdominal distension in the right lower quadrant. She had undergone a partial resection of a cholesteatoma at the right temporal lobe of the cerebrum 30 years previously, and a ventriculoperitoneal shunt (VPS) tube had been placed with drainage into the right lower peritoneal cavity. The patient developed paralytic ileus in December 1966, and ultrasound and computed tomography of the abdomen revealed a cystic mass in the right lower quadrant without lymphadenopathies or masses. Cytologic examinations of the fluid in the cystic mass revealed signs of malignant lymphoma. After the resection of the cystic mass, lymphoma cells were detected in the fluid, but the wall of the cyst consisted of only fibrous tissues. Results of immunophenotypic analysis of the lymphoma cells by immunocytochemistry or flow cytometry were positive for CD19, CD20, CD22, CD45, and HLA-DR but negative for CD45RO, CD3, CD4, and CD8. The genome of human herpes virus (HHV)-8 was not detected in the lymphoma cells, but Epstein-Barr (EB) nuclear antigen 1 and EB virus (EBV)-encoded small nuclear RNAs were detected. Chromosome analysis by the G-banding method showed complicated abnormalities including der(8)t(2;8)(q31;q24), but Southern blotting analysis suggested that the c-myc oncogene did not participate in the lymphomagenesis. The patient's disease was diagnosed as HHV-8-negative primary effusion lymphoma (PEL). The long-standing inflammatory stimulation by a VPS tube might have contributed to the clonal evolution of EBV-infected lymphocytes. resulting in the development of PEL.