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目的探讨一期脑室-腹腔分流联合颅骨修补术对脑积水的临床效果。方法对于脑外伤后颅骨缺损伴脑积水的62例患者,分别随机采用一期脑室-腹腔分流联合颅骨修补术30例(A组),32例分期手术(B组)进行治疗。结果①疗效:两组间比较差异无统计学意义(P>0.05)。②并发症:A组分流过度、硬膜下积液及血肿的发生率分别为3.33%(1/30)和6.67%(2/30),B组分别为21.88%(7/32)和43.75%(14/32),两组比较差异有统计学意义(P<0.05);分流管堵塞、分流感染及切口脑脊液漏等并发症两组间差异无统计学意义(P>0.05)。结论一期联合手术能显著降低术后并发症,是脑外伤后脑积水合并颅骨缺损患者更为理想的治疗方法。
Objective To investigate the clinical effect of a ventricle-peritoneal shunt combined with skull repair on hydrocephalus. Methods Sixty-two patients with skull defect and hydrocephalus after traumatic brain injury were randomly divided into three groups: group A (30 cases) and group B (32 cases). Results ① Efficacy: There was no significant difference between the two groups (P> 0.05). Complications: The rates of component A overflow, subdural effusion and hematoma were 3.33% (1/30) and 6.67% (2/30) respectively in group B, 21.88% (7/32) and 43.75 % (14/32) respectively. The differences between the two groups were statistically significant (P <0.05). There were no significant differences between the two groups in the incidence of shunt, shunt infection and cerebrospinal fluid leakage (P> 0.05). Conclusion One-stage combined surgery can significantly reduce postoperative complications and is a more ideal treatment for patients with hydrocephalus and skull defects after traumatic brain injury.