脑积水合并颅骨缺损同期手术与分期手术的效果比较

发布时间：2018-04-04 01:18

本文选题：脑积水　切入点：颅骨缺损　出处：《中国医药导报》2016年35期

【摘要】：目的比较分析脑积水合并颅骨缺损同期手术与分期手术的效果。方法选择2012年2月~2014年1月广西壮族自治区江滨医院收治的54例脑积水合并颅骨缺损患者,根据随机数字表法将其随机分为同期手术组(27例)和分期手术组(27例),同期手术组同期行脑室-腹腔分流术和颅骨修补术,分期手术组在脑室-腹腔分流术后4周~7个月后行颅骨修补术,比较两组患者分流效果、神经功能恢复情况、并发症发生率、生活质量、医疗费用、再次手术情况。结果两组分流效果比较差异无统计学意义(P0.05);同期手术组神经功能恢复的优良率显著高于分期手术组,差异有统计学意义(P0.05);同期手术组并发症发生率为11.11%,分期手术组为29.63%,两组比较差异无统计学意义(P0.05);同期手术组健康调查简表(SF-36)中的心理健康和总体健康评分均显著高于分期手术组(P0.05);同期手术组的医疗费用显著低于分期手术组(P0.05);两组均有1例患者行再次手术。结论虽然同期行脑室-腹腔分流术和颅骨修补术在脑积水合并颅骨缺损中的分流效果与分期手术无异,但它在神经功能恢复、并发症、患者心理健康和医疗费用上更具优势,值得临床优先考虑使用。
[Abstract]:Objective to compare and analyze the effect of simultaneous operation and stage operation on hydrocephalus complicated with skull defect.Methods from February 2012 to January 2014, 54 patients with hydrocephalus complicated with skull defect were treated in Jiangbin Hospital of Guangxi Zhuang Autonomous region.According to the method of random number table, the patients were randomly divided into two groups: the simultaneous operation group (n = 27) and the staging operation group (n = 27).The patients in the operation group were treated with cranioplasty 4 weeks to 7 months after the operation. The effect of shunt, the recovery of nerve function, the incidence of complications, the quality of life, the cost of medical treatment, and the re-operation were compared between the two groups.Results there was no significant difference in shunt effect between the two groups (P 0.05), and the excellent and good rate of nerve function recovery in the operation group was significantly higher than that in the stage operation group.The incidence of complications in the operation group was 11.1111 and 29.63 in the operation group. There was no significant difference between the two groups (P 0.05). The scores of mental health and overall health were significant in SF-36.The medical cost of the operation group was significantly lower than that of the stage operation group (P 0.05), and one patient in both groups underwent reoperation.Conclusion although the effect of ventricle-celiac shunt and cranioplasty in patients with hydrocephalus complicated with skull defect is no different from that of staging surgery, it has more advantages in the recovery of neurological function, complications, mental health and medical expenses of patients with hydrocephalus.It is worthy of clinical priority.
【作者单位】：广西壮族自治区江滨医院神经外科;
【分类号】：R651.1

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