脑出血术后颅骨缺损合并脑积水同期行颅骨修补术和脑室-腹腔分流术疗效分析  

Efficacy analysis of concurrent skull repair and ventriculoperitoneal shunt in patients with skull defects and hydrocephalus after cerebral hemorrhage surgery

作　　者：冯杰 张仁豪 李宇 姜之全 FENG Jie;ZHANG Renhao;LI Yu;JIANG zhiquan(Department of Neurosurgery,The First Affiliated Hospital of Bengbu Medical University,Bengbu 233000,Anhui,China)

机构地区：[1]蚌埠医科大学第一附属医院神经外科,安徽蚌埠233000

出　　处：《右江民族医学院学报》2024年第3期355-358,共4页Journal of Youjiang Medical University for Nationalities

基　　金：安徽省财政支持项目/重点项目(AHWJ2023A10099)。

摘　　要：目的分析脑出血术后颅骨缺损合并脑积水同期行颅骨修补术和脑室-腹腔分流术(VP分流术)的疗效。方法选取2021年1月至2023年9月蚌埠医科大学第一附属医院神经外科收治的45例脑出血术后骨缺损合并脑积水患者,观察组为同期行颅骨修补术和VP分流术21例,对照组为VP分流术后3个月内行颅骨修补术24例。统计术后并发症发生率,术前、术后2周比较V/Bp值,术前、术后3个月比较NIHSS评分、ADL评分、预后优良率。结果术前观察组与对照组V/Bp值差异无统计学意义(P>0.05);术后2周两组V/Bp值均明显降低,且观察组数值较对照组更低(P<0.05)。术前观察组与对照组NIHSS、ADL评分差异无统计学意义(P>0.05);术后3个月观察组与对照组NIHSS、ADL评分均明显改善,且观察组评分较对照组改善更多(P<0.05)。术后3个月预后优良率观察组(95.24%)高于对照组(70.83%)(P<0.05)。术后观察组并发症发生率(4.76%)低于对照组(33.33%)(P<0.05)。结论脑出血术后颅骨缺损合并脑积水患者同期行颅骨修补术和VP分流术术后患者脑积水改善明显、神经功能和生活能力提高、预后优良率高且并发症少,患者术后疗效更好。Objective To analyze the efficacy of concurrent skull repair and ventriculoperitoneal(VP)shunt in patients with skull defects and hydrocephalus after cerebral hemorrhage surgery.Methods This study included 45 patients with skull defects and hydrocephalus following cerebral hemorrhage surgery,treated between January 2021 and September 2023 at the Neurosurgery Department of The First Affiliated Hospital of Bengbu Medical University.The patients were divided into two groups:the study group(21 cases)undergoing concurrent skull repair and VP shunt,and the control group(24 cases)undergoing skull repair within three months after VP shunt.The incidence of postoperative complications was analyzed and V/Bp values were compared before surgery and two weeks after surgery.The NIHSS and ADL scores were compared before surgery and three months after surgery.The excellent prognosis rates of two groups of patients were also calculated.Results The preoperative V/Bp values between the two groups had no statistical significance(P>0.05).Two weeks postoperatively,both groups exhibited significantly reduced V/Bp values,with the study group showing a greater reduction(P<0.05).There was no statistical significance in NIHSS and ADL scores between the two groups before surgery(P>0.05).Both NIHSS and ADL scores were improved three months postoperatively in both groups,with the study group demonstrating better outcomes(P<0.05).The excellent prognosis rate was significantly higher in the study group(95.24%)compared to the control group(70.83%)three months postoperatively(P<0.05).The study group also had a lower incidence of postoperative complications(4.76%)compared to the control group(33.33%)(P<0.05).Conclusion Concurrent skull repair and VP shunt in patients with skull defects and hydrocephalus after cerebral hemorrhage surgery significantly alleviates hydrocephalus,enhances neurological function and daily living abilities,and leads to a higher rate of excellent prognosis with fewer postoperative complications,thus improving overall patien

关 键 词：脑出血 颅骨缺损 脑积水 颅骨修补术 脑室腹膜分流术 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]