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目的创伤性脑损伤后不同程度脑积水患者脑室腹腔分流术治疗的临床疗效。方法选取2013年1月-2015年1月苏州大学附属第一人民医院收治的创伤性脑损伤后脑积水患者60例,所有患者随机分为试验组与对照组各30例。试验组行脑室腹腔分流;对照组行腰大池腹腔分流。比较2组患者的临床疗效。将试验组患者以脑积水严重程度分为3组,组间对比临床疗效与并发症情况。结果试验组患者术后脑积水消失27例(90.0%),对照组术后脑积水消失23例(76.67%),差异对比有显著统计学意义(P<0.01);试验组并发症发生率6.67%(2/30),对照组并发症发生率13.33%(4/30),差异对比有统计学意义(P<0.05);术后回访试验组2例、对照组4例脑室未恢复正常,差异对比无统计学意义(P>0.05);试验组术后神经功能缺损评分(14.2±5.0)分,对照组术后神经功能缺损评分(21.4±6.7)分,差异对比有统计学意义(P<0.05)。轻度脑积水患者脑室腹腔分流术的临床治疗效果明显优于重度脑积水患者,差异对比有显著统计学意义(P<0.01)。结论以脑室腹腔分流术治疗创伤性脑损伤后脑积水患者,其临床疗效明显优于腰大池腹腔分流术,且患者脑积水程度越轻,治疗效果越优,故临床行脑腹腔分流术需坚持及早发现,及时治疗的原则,以促进患者康复。
Objective To evaluate the clinical effect of intraventricular peritoneal shunt in patients with hydrocephalus after traumatic brain injury. Methods Sixty patients with hydrocephalus after traumatic brain injury were enrolled in the First People’s Hospital Affiliated to Soochow University from January 2013 to January 2015. All patients were randomly divided into experimental group and control group with 30 cases each. Experimental group ventricle peritoneal shunt; control group, lumbar cistern peritoneal shunt. The clinical effects of two groups were compared. Patients in the test group were divided into 3 groups according to the severity of hydrocephalus. Clinical efficacy and complications were compared between groups. Results In the experimental group, hydrocephalus disappeared in 27 cases (90.0%) and in the control group disappeared in 23 cases (76.67%), the difference was statistically significant (P <0.01). Complication occurred in the experimental group The rate of complications was 6.67% (2/30) in the control group and 13.33% (4/30) in the control group, with significant difference between the two groups (P <0.05) (P> 0.05). The postoperative neurological deficit score (14.2 ± 5.0) in the experimental group and the neurological deficit score in the control group (21.4 ± 6.7), the difference was statistically significant (P <0.05). The clinical effect of intraventricular peritoneal shunt in patients with mild hydrocephalus was significantly better than that of patients with severe hydrocephalus, the difference was statistically significant (P <0.01). Conclusion Intraperitoneal peritoneal shunt for the treatment of hydrocephalus after traumatic brain injury in patients with clinical efficacy was significantly better than the lumbar cistern peritoneal shunt, and patients with lighter hydrocephalus, the more effective treatment, so the clinical cerebral ipsilateral shunt required Adhere to the principle of early detection and timely treatment to promote patient rehabilitation.