【摘要】 目的研究同期应用脑室-腹腔分流术和颅骨修补术与分期应用在治疗脑外伤伴积水的效果差异。方法选取我院2013年1月~2017年6月收治的62例脑外伤伴积水患者作为研究对象,根据脑室-腹腔分流术与颅骨修补术的时间间隔分为同期组(35例)与分期组(27例),同期组采用两种手术同期进行;分期组采用先行脑室-腹腔分流术,间隔1~3个月后再行颅骨修补术。比较两组患者治疗前后的日常生活能力(Barther指数)、四肢运动功能(Fugl-Meyer指数)、格拉斯哥昏迷指数(GCS)、临床疗效和并发症发生率。结果两组患者治疗前的Barther指数、Fugl-Meyer指数与GCS指数比较,差异无统计学意义(P>0.05)。治疗后,两组患者的Barther指数、Fugl-Meyer指数与GCS指数均明显上升,且同期组上升幅度显著大于分期组,同时同期组的GOS指数高于分期组,差异均有统计学意义(P<0.05)。同期组患者的治疗优良率明显高于分期组,差异有统计学意义(P<0.05)。同期组患者并发症5例,分期组患者并发症10例,同期组患者的并发症发生率(14.29%)显著低于分期组的37.04%,差异有统计学意义(χ2=4.302;P=0.038)。结论同期应用脑室-腹腔分流术与颅骨修补术在治疗脑外伤伴积水的疗效和预后较好,且相较于分期方式具有功能恢复快、术后并发症少的优势。更多还原

【Abstract】 Objective To observe the different effects of homochronous and staging operative treatment of ventricular-peritoneal shunt and skull repair for traumatic brain injury with hydrocephalus.Methods Sixty-two patients with traumatic brain injury and hydronephrosis admitted to our hospital from January 2013 to June 2017 were selected as the research objects,and divided into the same period group(35 cases) and the staging group(27 cases) according to the time interval between ventriculoperitoneal shunt and skull repair,and the same period group was conducted with two kinds of operations at the same time.The staging group was treated with ventriculoperitoneal shunt first,and then cranioplasty was performed after interval of 1-3 months.The daily life ability(Barther index),limb movement function(FuglMeyer index),Glasgow coma index(GCS),clinical efficacy and complication rate of the two groups were compared before and after treatment.Results There was no significant difference in Bart her index,fugl-Meyer index and GCS index between the two groups before treatment(P>0.05).Barther index,Fugl-Meyer index and GCS index of the two groups increased significantly after treatment,and the rising amplitude of the same period group was significantly larger than that of the staging group,and GOS index of the same period group was higher than that of the staging group,with statistically significant difference(P<0.05).The excellent and good rate of treatment in the same period group was significantly higher than that in the stage group,and the difference was statistically significant(P<0.05).There were 5 patients with complications in the same period and 10 patients with complications in the staging group,and the complication rate of14.29% in the same period was significantly lower than that of 37.04% in the staging group,the difference was statistically significant(χ2=4.302;P=0.038).Conclusion Homochronous ventricular-peritoneal shunt and skull repair has a better curative effect and prognosis than staging surgery,it has the advantages of fast recovery,less postoperative complications.更多还原