重型颅脑损伤术后脑积水颅骨缺损同期治疗研究

目的评价早期同期行脑室．腹腔分流加颅骨修补术治疗重型颅脑损伤术后颅骨缺损合并脑积水的疗效。方法将手术治疗的重型颅脑损伤术后颅骨缺损合并脑积水的患者53例，随机分为两组；A组36例，早期同期行脑室一腹腔分流加颅骨修补术；B组17例，分次手术。结果术后有效率、分流感染率差异均有统计学意义，分流不足、皮下积液差异均无统计学意义。结论早期同期行脑室一腹腔分流加颅骨修补术较分次手术的疗效显著，并可降低分流感染的发生率，是重型颅脑损伤术后颅骨缺损合并脑积水患者有效的、经济实用的治疗手段。

Study on treatment of postoperative hydrocephalus and skull defect following severe craniocerebral injury

Objective To evaluate the effect of early single-stage synchronous ventriculoperitoneal shunt （VPS） and cranioplasty for the patients with postoperative skull defect and hydrocephalus following severe eraniocerebral injury. Methods The 53 patients with postoperative skull defect and hydrocephalus following severe craniocerebral injury operation were divided into two groups, including 36 cases （group A） underwent early synchronous operation and 17 cases （group B ）underwent two-stage operations. Results There were no significant differences in the underdrainage or scalp infection between the two groups, but the rates of curative effect were significantly higher and the oceurrent rates of shunt infection were significantly lower in group A than those in group B. Conclusion Adoption of early single-stage ventriculoperitoneal shunt and cranioplasty has a significantly better curative effect than two-stage operations, and can decrease the oceurrent rates of shunt infection, so it is an effective, economical and practical therapeutic means to the patients with postoperative skull defect and hydrocephalus following severe craniocerebral injury.