CAJ | 학술논문

目的探讨分期脑室-腹腔分流术(V-P分流术)及颅骨修补术在外伤性脑积水合并颅骨缺损患者中的临床应用效果.方法采用分期V-P分流术及颅骨修补术治疗63例外伤性脑积水合并颅骨缺损患者,观察其临床疗效.结果术后一个月患者的头痛、恶心、呕吐、意识障碍、精神障碍、肢体活动障碍以及认知障碍等临床症状与术前比较显著减少(P<0.05或P<0.01),同时患者格拉斯哥昏迷指数(GCS)评分显著增高(P<0.01).术后6个月内无死亡病例.术后1个月时51例(81.0%)神经功能改善;术后6个月恢复良好者33例(52.4%),中残20例(31.7%),重残及植物生存10例(15.9%).术后发生分流管堵塞、颅内感染、腹腔感染、过度分流各1例,对症治疗后好转.结论分期V-P分流术与颅骨修补术治疗外伤性脑积水合并颅骨缺损,疗效确切,其能够有效缓解患者的临床症状和体征,缓解神经功能障碍,同时减少术后并发症发生.
목적 탐토분기뇌실-복강분류술(V-P분류술)급로골수보술재외상성뇌적수합병로골결손환자중적림상응용효과.방법 채용분기V-P분류술급로골수보술치료63예외상성뇌적수합병로골결손환자,관찰기림상료효.결과 술후일개월환자적두통、악심、구토、의식장애、정신장애、지체활동장애이급인지장애등림상증상여술전비교현저감소(P<0.05혹P<0.01),동시환자격랍사가혼미지수(GCS)평분현저증고(P<0.01).술후6개월내무사망병례.술후1개월시51례(81.0%)신경공능개선;술후6개월회복량호자33례(52.4%),중잔20례(31.7%),중잔급식물생존10례(15.9%).술후발생분류관도새、로내감염、복강감염、과도분류각1례,대증치료후호전.결론 분기V-P분류술여로골수보술치료외상성뇌적수합병로골결손,료효학절,기능구유효완해환자적림상증상화체정,완해신경공능장애,동시감소술후병발증발생.
Objective To investigate the clinical effects of staging ventricule-peritoneal (V-P) shunt surgery and cranioplasty on traumatic hydrocephalus complicated by cranial defect. Methods Sixty-three patients with trau-matic hydrocephalus complicated by cranial defect were treated with staging V-P shunt surgery and cranioplasty, and the clinical effects were analyzed. Results One month after the treatment, clinical symptoms such as headache, nau-sea, vomiting, disturbance of consciousness, mental disorder, limb movement disorder and cognitive disorder were sig-nificantly decreased (P<0.05 or P<0.01), and the GCS scores were significantly higher (P<0.01). There was no death in the study 6 months after the treatment. The neurological function of 51 patients (81.0%) were improved one months after the surgery. Six months after the surgery, there were 33 cases with good recovery (52.4%), 20 cases with moder-ate disability (31.7%), and 10 cases with severe disability and plant survival (15.9%). Postoperative adverse reactions such as shunt tube obstruction, intracranial infection, abdominal cavity infection and excessive diversion (one case of each) were improved after symptomatic treatment. Conclusion Staging V-P shunt surgery and cranioplasty are effec-tive in treating traumatic hydrocephalus complicated by cranial defect, which can effectively improve clinical symp-toms and signs, alleviate neural dysfunction, and reduce the incidence of postoperative complications.