脑室-腹腔分流术在颅脑外伤并发脑积水患者中的应用

【目的】探讨颅脑外伤并发脑积水的原因及脑室腹腔分流术在治疗患者中的作用。【方法】回顾本院2007年1月至2010年12月收治的63例颅脑外伤后并发脑积水行脑室-腹腔分流术患者的情况，对其临床资料、并发症及其预后进行分析。【结果】所有患者均在伤后3个月内进行手术，术后并发颅内感染3例（4．7％），分流管阻塞3例（4．7％）；术后意识及神经功能障碍不同程度的改善患者56例（88．9％）；恢复良好33例（52．4％），中度残疾20例（31．7％），重度残疾8例（12．7％），植物生存2例（3．2％），无手术死亡病例。【结论】脑室腹腔分流术是治疗颅脑外伤并发脑积水的有效方法，并发症少，可以提高患者的生存质量，明显改善患者意识及神经功能障碍，值得临床推广。

Application of Ventriculoperitoneal Shunt in Traumatic Brain Injury Patients with Hydrocephalus

[Objective] To explore the causes of traumatic brain injury with hydrocephalus and the role of ventriculo- peritoneal shunt in the treatment of these patients. [Methods] The clinical data, complications and prognosis of 63 cases of traumatic brain injury complicated with hydrocephalus undergoing ventriculoperitoneal shunt in our hospital from Jan. 2007 to Dec. 2010 were analyzed retrospectively. [Results] Operations of all the patients were performed within 3 months after trauma. The postoperative complications included intraeranial infection（3 cases, 4. 7 % ） and obstruction of shunt tube（3 cases, 4.7%）. The postoperative consciousness and neurological function impairment were improved in 56 cases （88.9% ）. The 33 cases（5 2.4 % ） recovered well. Moderate disability occurred in 20 cases（31.7 % ） and severe disability occurred in 8 cases（12.7 % ）. Two cases（3.2 % ） survived in vegetative state. No one died. [Conclusion] Ventriculoperitoneal shunt for the treatment of traumatic brain injury complicated with hydrocephalus is an effective method. It can obviously improve the patients＇ quality of life, consciousness and nerve function impairment, and has less complication. Therefore, it is worthy of being extended in clinical practice.