颅骨缺损修补术联合同期脑室腹腔分流术治疗颅骨缺损合并脑积水的效果  

Effect of cranioplasty combined with simultaneous ventriculoperitoneal shunt in the treatment of cranial defect with hydrocephalus

作　　者：李元朋[1] 康宁[1] 魏欢 李康[1] LI Yuanpeng;KANG Ning;WEI Huan;LI Kang(Neurosurgery Department,Baoji People's Hospital,Baoji 721000,China;Endocrinology Department,Baoji People's Hospital,Baoji 721000,China)

机构地区：[1]宝鸡市人民医院神经外科,陕西宝鸡721000 [2]宝鸡市人民医院内分泌科,陕西宝鸡721000

出　　处：《临床医学研究与实践》2021年第18期61-63,共3页Clinical Research and Practice

摘　　要：目的分析颅骨缺损修补术联合同期脑室腹腔分流术治疗颅骨缺损合并脑积水的效果。方法收集在我院进行颅骨缺损修补术联合脑室腹腔分流术治疗的50例颅骨缺损合并脑积水患者的临床资料进行回顾分析,根据不同手术方案将其分为同期组和分期组,各25例。同期组进行颅骨缺损修补术联合同期脑室腹腔分流术治疗;分期区在脑室腹腔分流术后3~6个月再行颅骨修补术治疗。比较两组手术效果。结果同期组的手术时间、住院时间均短于分期组,术中出血量少于分期组,住院费用低于分期组(P<0.05)。手术后,同期组NIHSS评分显著低于分期组,MMSE、MoCA评分显著高于分期组(P<0.05)。同期组的恢复良好率高于分期组,轻度残疾率低于分期组(P<0.05)。分期组的并发症总发生率明显高于同期组(P<0.05)。结论颅骨缺损修补术联合同期脑室腹腔分流术治疗颅骨缺损合并脑积水的手术时间及术后恢复期明显短于分期手术,其能有效改善患者的神经功能和认知功能,提高恢复优良率,降低手术相关并发症发生率。Objective To analyze the effect of cranioplasty combined with simultaneous ventriculoperitoneal shunt in the treatment of cranial defect with hydrocephalus.Methods The clinical data of 50 patients with cranial defect complicated with hydrocephalus who were treated by cranioplasty combined with ventriculoperitoneal shunt in our hospital were collected and analyzed retrospectively.According to different surgical schemes,the patients were divided into same period group and staging group,with 25 cases in each group.In the same period group,cranioplasty combined with ventriculoperitoneal shunt was performed at the same stage;in the staging group,cranioplasty was performed at 3-6 months after ventriculoperitoneal shunt.The operation effects of the two groups were compared.Results The operation time and hospital stay of the same period group were shorter than those of the staging group,the intraoperative blood loss volume was less than that of the staging group,and the hospitalization cost was lower than that of the staging group(P<0.05).After operation,NIHSS score in the same period group was significantly lower than that in the staging group,while MMSE and MoCA scores were significantly higher than those in the staging group(P<0.05).The rate of good recovery of the same period group was higher than that of the staging group,and the mild disability rate was lower than that of the staging group(P<0.05).The total incidence of complications in the staging group was significantly higher than that in the same period group(P<0.05).Conclusion The cranioplasty combined with simultaneous ventriculoperitoneal shunt in the treatment of cranial defect with hydrocephalus has shorter operation time and postoperative recovery period than staged operation.It can effectively improve the neurological function and cognitive function of patients,improve the excellent and good recovery rate,and reduce the incidence of surgery-related complications.

关 键 词：颅骨缺损修补术 同期脑室腹腔分流术 颅骨缺损 脑积水 

分 类 号：R683.5[医药卫生—骨科学]