早期脑室分流及颅骨修补治疗颅脑外伤术后脑积水  

Early ventriculo-peritoneal shunt and cranioplasty for the postoperative hydrocephalus in traumatic brain injury

作　　者：万青[1] 崔益钿[1] 宋洋[1] 蔡廷江[1] 江小伟[1] 

机构地区：[1]中国人民解放军第九七医院神经外科,江苏徐州221004

出　　处：《徐州医学院学报》2008年第8期530-533,共4页Acta Academiae Medicinae Xuzhou

摘　　要：目的探讨早期一次性脑室腹腔分流及颅骨修补在颅脑外伤术后脑积水治疗中的作用。方法回顾性分析45例早期同期行脑室腹腔分流及颅骨修补手术的颅脑外伤病例,对其临床资料、并发症及其预后进行总结。结果本组手术时间均在伤后3个月内进行,术后并发分流管阻塞2例(4.4%),颅内感染2例(4.4%);术后意识及神经功能障碍不同程度的改善40例(88.9%);恢复良好24例(53.3%),中度残疾11例(24.4%),无手术死亡病例。结论颅脑损伤术后颅骨缺损、脑积水、脑膨出严重影响患者预后,早期同期行脑室腹腔分流及颅骨修补手术并发症少,可明显改善患者意识及神经功能障碍,改善患者预后,值得推广。Objective To evaluate the early one - stage ventriculoperitoneal shunt and cranioplasty for treating traumatic brain injury with hydrocephalus and skull defect. Methods Retrospect study was made on 45 patients who were found to have hydrocephalus after the surgical intervention of the traumatic brain injury complicated by skull defect. Results Early one - stage operation of ventriculo - peritoneal shunt and cranioplasty was performed within 3 months after trauma. The clinical complications of the operation included block of the shunt tube （2 cases, 4.4% ）arid skull infection （2 cases, 4.4% ）. 40 patients （88.9%） got improved with consciousness and nerve function, including 24 cases of good recovery and 11 cases of moderate deficit. There was no operative mortality. Conclusion The complications of skull defect, brain swelling and hydrocephalus after traumatic brain injury operation will seriously threat the patient＇s prognosis. Early one- stage ventriculo -peritoneal shunt and cranioplasty, causing few complications, can improve patients＇ consciousness, nerve function and outcome, and hence, is worthy of recommendation.

关 键 词：颅脑损伤 脑室腹腔分流术 颅骨修补术 脑积水 

分 类 号：R651.1[医药卫生—外科学]