同期分流与分期分流联合颅骨修补术治疗颅脑损伤去骨瓣减压术后合并交通性脑积水患者的效果比较  

Comparison of effects of concurrent shunt and staging shunt combined with cranioplasty in treatment of patients with communicating hydrocephalus after decompressive craniectomy for craniocerebral injuries

作　　者：李斌 LI Bin(The Second Department of Neurosurgery of Central Hospital of Yingkou Economic and Technological Development Zone(Yingkou Sixth People’s Hospital),Yingkou 115007 Liaoning,China)

机构地区：[1]营口经济技术开发区中心医院(营口市第六人民医院)神经外二科,辽宁营口115007

出　　处：《中国民康医学》2021年第23期147-149,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:比较同期分流与分期分流联合颅骨修补术治疗颅脑损伤去骨瓣减压术后合并交通性脑积水患者的效果。方法:选取82例颅脑损伤去骨瓣减压术后合并交通性脑积水患者为研究对象,按照随机数字表法分为对照组和观察组各41例。对照组行分期分流联合颅骨修补术治疗,观察组行同期分流联合颅骨修补术治疗,两组均术后随访6个月。比较两组临床疗效、意识状态[格拉斯哥昏迷量表(GCS)]评分、预后情况[格拉斯哥预后量表(GOS)]评分、神经功能[美国国立卫生院卒中量表(NIHSS)]评分和术后并发症发生率。结果:观察组治疗总有效率为95.12%,高于对照组的80.49%,差异有统计学意义(P<0.05);治疗后,两组GCS评分、GOS评分均高于治疗前,且观察组高于对照组,两组NIHSS评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为4.88%(2/41),低于对照组的19.51%(8/41),差异有统计学意义(P<0.05)。结论:同期分流联合颅脑修补术治疗颅脑损伤去骨瓣减压术后合并交通性脑积水患者可提高治疗总有效率、GCS评分和GOS评分,降低NIHSS评分和并发症发生率,优于分期分流联合颅脑修补术治疗效果。Objective:To compare effects of concurrent shunt and staging shunt combined with cranioplasty in treatment of patients with communicating hydrocephalus after decompressive craniectomy for craniocerebral injuries.Methods:82 patients with communicating hydrocephalus after decompressive craniectomy for craniocerebral injuries were selected as the research objects,and were divided into control group and observation group according to the random number table method,41 cases in each group.The control group was treated with staging shunt combined with cranioplasty,while the observation group was treated with concurrent shunt combined with cranioplasty.Both groups were followed up for 6 months after the surgery.The clinical efficacy,the consciousness state[Glasgow coma scale(GCS)]score,the prognosis[Glasgow outcome scale(GOS)]score,the neurological function[National Institutes of Health stroke scale(NIHSS)]score,and the postoperative complication rate were compared between the two groups.Results:The total effective rate of treatment in the observation group was 95.12%,which was higher than 80.49%in the control group,and the difference was statistically significant(P<0.05).After the treatment,the GCS score and GOS score of the two groups were higher than those before the treatment,and those of the observation group were higher than those of the control group;the NIHSS scores of the two groups were lower than those before the treatment,and that of the observation group was lower than that of the control group;and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 4.88%(2/41),which was lower than 19.51%(8/41)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Concurrent shunt combined with cranioplasty in the treatment of the patients with communicating hydrocephalus after decompressive craniectomy for craniocerebral injuries can improve the total effective rate of treatment,the GCS score and the GOS score,and reduc

关 键 词：颅脑损伤 交通性脑积水 脑室腹膜分流术 颅骨修补术 同期分流 NIHSS评分 并发症 

分 类 号：R651.15[医药卫生—外科学]