同期颅骨修补联合脑室-腹腔分流术对脑外伤预后的影响

目的探讨颅脑创伤手术后颅骨缺损伴脑积水,同期行颅骨修补联合脑室-腹腔分流术对患者预后的影响。方法 51例脑外伤手术后颅骨缺损伴脑积水患者,随机分为治疗组(早期分流同期颅骨修补组)24例及对照组(早期分流后延期颅骨修补组)27例。观察比较两组颅脑损伤手术后12个月的疗效和并发症。结果治疗组格拉斯哥预后评分(GOS)较对照组有显著提高。治疗组分流过度及术后硬膜下积液/血肿等并发症的发生率均明显低于对照组。结论同期行脑室-腹腔分流联合颅骨修补术,不仅能显著改善患者神经功能障碍,避免严重并发症,且能极大地降低并发症。

EFFECT OF EARLY CRANIOPLASTY AND VENTRICULOPERITONEAL SHUNT ON PROGNOSIS OF TRAUMATIC BRAIN INJURY

Objective To investigate the effect of early cranioplasty and ventriculoperitoneal shunt on the prognosis of traumatic brain injury.Methods 51 patients with the skull defect and hydrocephalus were randomly divided into observation group of 24 cases(given early ventriculoperitoneal shunt and in the same turn cranioplasty) and control group of 27 cases(given early ventriculoperitoneal shunt but postponed cranioplasty).Compare the efficacy and complications of two groups 12 months after surgery of traumatic brain injury.Results GOS of observation group significantly increased than the control group.The incidence rate of shunt over-and postoperative subdural effusion/hematoma and other complication in observation group was significantly lower than that in the control group.Conclusion Early line ventriculoperitoneal shunt and intracranial repair of combined traumatic hydrocephalus in patients with skull defects not only can significantly improve the neurological dysfunction,no severe complications,and greatly reduced the complication rate.