摘要
目的 分析颅脑外伤患者实施脑室腹腔分流术与骨瓣减压颅骨修补术治疗的临床疗效以及对患者生存情况的影响。方法 抽取2022年10月-2023年10月期间我院收治的颅脑外伤患者50例,以随机信封法分组,两组患者均接受脑室腹腔分流术和去骨瓣减压颅骨修复术治疗,区别在于,观察组为并行治疗,对照组为分期治疗。对比两组患者术后7d颅内压情况以及严重颅脑外伤残疾评定量表(DRS)评分情况。结果 (1)术后7d,观察组患者颅内压低于术前,且低于对照组(P<0.05);(2)术后3个月,观察组患者DRS评分照比术前明显下降,且低于对照组(P<0.05)。结论 对颅脑外伤患者实现同期脑室腹腔分流术与去骨瓣减压颅骨修补术可显著降低颅内压,并可促进患者术后生存质量提升。
关键词: 脑室腹腔分流术;颅脑外伤;去骨瓣减压颅骨修补术
Abstract
Objective To analyze the clinical efficacy of ventriculoperitoneal shunt and cranioplasty with decompression of bone flap in patients with craniocerebral trauma and the impact on the survival of the patients. Methods Fifty patients with craniocerebral trauma admitted to our hospital from October 2022 to October 2023 were selected and divided into two groups by random envelope method. Both groups received ventriculoperitoneal shunt and craniotomy decompressive cranioplasty. The difference was that the observation group received concurrent treatment, while the control group received staged treatment. The intracranial pressure (ICP) and the score of severe craniocerebral injury Disability Rating Scale (DRS) at 7 days after operation were compared between the two groups. Results (1) The intracranial pressure of observation group was lower than that of control group 7 days after operation (P < 0.05); (2) Three months after surgery, DRS scores in the observation group were significantly lower than those before surgery, and lower than those in the control group (P < 0.05). Conclusion Simultaneous ventriculoperitoneal shunt and craniotomy can significantly reduce intracranial pressure and improve postoperative quality of life in patients with craniocerebral trauma.
Key words: Ventriculoperitoneal shunt; Traumatic brain injury; Decompressive cranioplasty with craniotomy
参考文献 References
[1] 黄富,赵振林,刘康峰,等.监测脑状态指数对不同脑功能损害程度颅脑外伤患者的指导意义[J]. 岭南急诊医学杂志,2021,26(5):469-471.
[2] 赵俊涛,赵明亮.不同时期行颅骨缺损修补术对颅脑外伤去骨瓣减压术后伴脑积水患者颅压及神经功能的影响[J]. 辽宁医学杂志,2022,36(3):19-22.
[3] 吴澎志.脑室腹腔分流术与去骨瓣减压颅骨修补术治疗颅脑外伤患者的临床效果及对生存情况的影响[J].中外医学研究,2023,21(15):19-23.
[4] 王辉.成人颅脑外伤去骨瓣减压术后脑积水脑室-腹腔分流术同期颅骨修补临床价值研究[J]. 河南外科学杂志, 2021, 27(5):27-29.
[5] 温良,杨小锋,江基尧.创伤性颅骨缺损成形术中国专家共识[J]. 中华神经外科杂志,2016,32(8):767-770.
[6] 卢荣加.早期室腹腔分流术与颅骨修补术治疗老年脑外伤患者的临床效果[J]. 中外医学研究,2021,19(26):158-161.
[7] 周大帅 早期脑室-腹腔分流术同期联合颅骨修补术治疗脑创伤伴脑积水的疗效观察 . 基层医学论坛, 2023 , 27 (22) :70-72
[8] 仲维琳 早期脑室-腹腔分流术同期联合颅骨修补术对脑外伤伴脑积水的应用价值及效果研究 . 黑龙江医药科学, 2019 ,42 (2) :157-158.