早期颅骨修补及脑室腹腔分流治疗脑外伤的临床疗效对比分析

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目的对比分析早期颅骨修补及脑室腹腔分流治疗脑外伤的临床疗效。方法将98例脑外伤患者随机分为对照组和观察组,每组49例,对照组患者行开颅手术后3个月,仅采用脑室腹腔分流治疗,观察组则在脑室腹腔分流治疗后立即进行颅骨修补术,观察两组患者术后不良反应发生情况,并比较手术前后格拉斯哥昏迷评分和格拉斯哥预后评分以及预后疗效。结果观察组分流管移位堵塞、术后感染、脑脊液渗漏、硬膜积液、脑部血肿发生率分别为2.04%、6.12%、8.16%、4.08%、6.12%明显低于对照组的12.24%、18.37%、24.49%、22.45%、18.37%,差异有统计学意义(P<0.05);手术前,两组患者GCS评分和GOS评分无显著差异(P>0.05),手术后,两组患者GCS评分和GOS评分较手术前均明显升高,且观察组较对照组升高更显著,差异有统计学意义(P<0.05);观察组和对照组治疗有效率分别为81.63%和53.06%,差异显著,有统计学意义(P<0.05)。结论早期颅骨修补及脑室腹腔分流治疗脑外伤可降低患者并发症发生率,改善患者预后情况,效果优于传统治疗方法,值得临床推广。 Objective To compare and analyze the clinical effect of early skull repair and ventriculoperitoneal shunt in the treatment of traumatic brain injury. Methods 98 cases of traumatic brain injury were randomly divided into control group and observation group, 49 cases in each group. Patients in control group were treated with intracerebroventricular shunt only 3 months after craniotomy. In observation group, Skull repair was performed to observe the postoperative adverse reactions in both groups. The Glasgow Coma Scale, Glasgow Prognosis Score and Prognosis were compared before and after surgery. Results The incidences of flow blockage, postoperative infection, cerebrospinal fluid leakage, dura mater effusion and cerebral hematoma were 2.04%, 6.12%, 8.16%, 4.08% and 6.12% respectively in the observation group, which were significantly lower than those in the control group %, 18.37%, 24.49%, 22.45% and 18.37%, respectively. There was no significant difference between the two groups in the GCS score and the GOS score before operation (P> 0.05) The GCS score and GOS score of patients were significantly higher than those before operation, and the observation group was more significant than the control group, the difference was statistically significant (P <0.05). The effective rates of the observation group and the control group were 81.63% and 53.06 %, The difference was significant, with statistical significance (P <0.05). Conclusion Early skull repair and intraperitoneal shunt can reduce the incidence of complications and improve the prognosis of patients with traumatic brain injury. The results are superior to the traditional treatment and worthy of clinical promotion.
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