脑室-腹腔分流术和颅骨修补术分期、同期治疗脑外伤合并脑积水患者的效果  

Effect of Ventriculo-peritoneal Shunt and Cranioplasty in Staging and Concurrent Treatment of Patients with Traumatic Brain Injury Complicated with Hydrocephalus

作　　者：蔡昭文 张晋宁[1] 江志贤[1] 林志忠[1] 李谋仪[1] 黄锦聪[1] CAI Zhaowen;ZHANG Jinning;JIANG Zhixian;LIN Zhizhong;LI Mouyi;HUANG Jincong(Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou 362200,China;不详)

机构地区：[1]福建医科大学附属泉州第一医院,福建泉州362200

出　　处：《中外医学研究》2023年第1期6-9,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨脑室-腹腔分流术(VPS)和颅骨修补术(CP)分期、同期治疗脑外伤合并脑积水患者的效果。方法:选择福建医科大学附属泉州第一医院在2016年7月-2021年7月收治的40例脑外伤合并脑积水患者,按照随机数字表法分为A组和B组,各20例。A组同期进行VPS和CP治疗,B组先行VPS后择期行CP。对比两组的神经细胞因子水平、意识状态、脑灌注与积水程度、并发症、预后。结果:术后7 d,A组的血清神经元特异性烯醇化酶(NSE)、S-100钙结合蛋白β(S-100β)、血清脑髓鞘碱性蛋白(MBP)水平低于B组(P<0.05)。术后7 d,A组的格拉斯哥昏迷量表(GCS)评分高于B组,脑积水程度低于B组(P<0.05),两组的脑灌注指数比较,差异无统计学意义(P>0.05)。治疗后6个月,两组的并发症发生率、预后情况比较,差异无统计学意义(P>0.05)。结论:无论分期或同期行VPS和CP术均能有效改善脑外伤合并脑积水患者的脑组织灌注和预后,且并发症均较少。但同期手术在减少神经组织损伤、改善患者的意识状态和减轻脑积水方面效果更佳。Objective:To investigate the effects of ventriculo-peritoneal shunt(VPS)and cranioplasty(CP)staging and concurrent treatment of patients with traumatic brain injury complicated with hydrocephalus.Method:A total of 40 patients with traumatic brain injury and hydrocephalus who were treated in Quanzhou First Hospital Affiliated to Fujian Medical University from July 2016 to July 2021were selected,and they were divided into group A and group B according to the random number table method,with 20 cases in each group.Group A underwent VPS and CP at the same time,and group B underwent VPS first and then performed CP.The levels of neurocytokines,state of consciousness,degree of cerebral perfusion and hydrops,complications and prognosis were compared between the two groups.Result:At 7 d after operation,the levels of serum neuron-specific enolase(NSE),S-100 calcium binding proteinβ(S-100β)and serum myelin basic protein(MBP)in group A were lower than those in group B(P<0.05).At 7 d after operation,the score of Glasgow coma scale(GCS)in group A was higher than that in group B,and the degree of hydrocephalus was lower than that in group B(P<0.05).There was no significant difference in cerebral perfusion index between the two groups(P>0.05).There were no significant differences in the incidence of postoperative complications and prognosis between the two groups at 6 months after treatment(P>0.05).Conclusion:No matter VPS and CP are performed by stage or concurrent,they can effectively improve the brain tissue perfusion and prognosis of patients with brain trauma and hydrocephalus,and the complications are less.However,the same period of operation is more effective in reducing nerve tissue damage,improving the patient’s state of consciousness and reducing hydrocephalus.

关 键 词：脑室-腹腔分流术 颅骨修补术 脑外伤合并脑积水 预后 

分 类 号：R651.1[医药卫生—外科学]