摘要
目的评价颅脑外伤去骨瓣减压术后颅骨缺损合并脑积水同期行V-P分流术及颅骨修补术的临床疗效,探讨其临床适用性。方法选择2012-05—2013-09于我院治疗的57例颅脑外伤去骨瓣减压术后颅骨缺损合并脑积水患者。随机分为试验组29例和对照组28例,试验组同期行脑室-腹腔分流术及颅骨修补术处理,对照组分期行脑室-腹腔分流术及颅骨修补术处理。观察并记录2组一般情况、治疗前后神经系统评分情况,观察临床疗效和并发症情况。结果试验组手术时间、术中出血量、皮瓣游离时间和住院时间均明显低于对照组(P<0.05);2组治疗后GOS评分、GCS评分、Fugl-Meyer评分和神经功能缺损评分明显优于治疗前(P<0.05),且试验组治疗后上述评分改善情况优于对照组(P<0.05);试验组良好率(58.62%)明显高于对照组(21.43%),差异有统计学意义(χ2=8.19,P=0.0042);试验组并发症发生率为6.89%(2/29),对照组为35.72%(10/28),差异有统计学意义(χ2=7.15,P<0.05)。结论颅脑外伤去骨瓣减压术后颅骨缺损合并脑积水同期行V-P分流术及颅骨修补术可以明显提高临床疗效,改善患者的神经系统症状,且不良反应少。
Objective To analyze the clinical effects of V-P shunt combined with cranioplasty in patients suffering both cranial defect and hydrocephalus after decompressive craniectomy.Methods Totally 57 cases conforming to the diagnosis of cranial defect and hydrocephalus after decompressive craniectomy in our hospital from May 2012 to September 2013 were selected and randomly divided into two groups.Experimental group containing 29 cases received V-P shunt and cranioplasty,and control group consisting of 28 patients received both ventricle-abdomen shunt and cranioplasty.The general conditions,blood loss during operation,free-flap time and hospitalization stays between two groups were recorded and observed.Results The operative time,blood loss,free-flap time and hospitalization stays in the experimental group were significantly lower than those in the control group（P〈0.05）.All of the GOS,GCS,Fugl-Meyer and NIHSS scores after treatment were significantly improved in both two groups（P〈0.05）and showed better improvement in the experimental group（P〈0.05）.And the experimental group（58.62%）got higher favorable-cure rate than the control group（21.43%）.Significantly statistical difference was found between the experimental group（6.89%,2/29）and the control group（35.72%,10/28）based on adverse events（χ^2=7.15,P〈0.05）.Conclusion V-P shunt combined with cranioplasty can improve clinical efficacy and relieve clinical symptoms in patients suffering both cranial defect and hydrocephalus after decompressive craniectomy,with less adverse reactions.
作者
徐春林
冯石萍
罗杰
熊学辉
胡均贤
Xu Chunlin Feng Shiping Luo Jie Xiong Xuehui Hu Junxian(Department of Neurosurgery ,the Central Hospital of Huanggang City, Huanggang 428000 ,Chin)
出处
《中国实用神经疾病杂志》
2016年第20期7-9,共3页
Chinese Journal of Practical Nervous Diseases
