目的:探讨早期颅骨修补和脑室腹腔分流术治疗脑外伤的疗效。方法:将58例颅骨缺损并脑积水患者分为对照组和治疗组。对照组行早期去骨瓣减压术,治疗组行早期颅骨修补和脑室腹腔分流术,评价两组的疗效。结果:对照组行早期去骨瓣减压术后,有11例(55%)患者神经功能障碍有不同程度的改善,按照GCS表进行预后判断,恢复良好7例(35%),中残8例(40%),重残2例(10%),植物生存2例(10%),死亡2例;术后治疗组患者均在1～3月内行早期颅骨修补并脑室腹腔分流术,术后未出现并发分流管堵塞,并发颅内感染2例;有33例(88%)患者意识及神经功能障碍不同程度改善;按照GCS表进行预后判断,恢复良好20例(56.6%),中残9例(23.7%),重残8例(21.1%),植物生存1例(2.6%),未出现手术死亡病例。结论:早期颅骨修补和脑室腹腔分流术可恢复脑的生理结构,明显缓解患者意识及神经功能障碍。 Objective: To investigate the effect of early cranial repair and ventricle shunt on brain trauma. Methods: 58 cases of skull defect and hydrocephalus were divided into control group and treatment group. The control group received early decompressive craniectomy. The treatment group received early skull repair and ventricular peritoneal shunt to evaluate the curative effect of the two groups. Results: In the control group, 11 cases (55%) had improvement of neurological dysfunction to some degree after decompressive craniectomy in the early stage. The prognosis was judged according to the GCS table and recovered well in 7 cases (35%), (40%), 2 cases of severe disability (10%), 2 cases of plant survival (10%) and 2 cases of death. The patients in the postoperative treatment group were treated with early cranial repair and ventricle peritoneal shunt within 1-3 months There were no cases of concurrent shunt occlusion and complicated with intracranial infection in 2 cases. In 33 cases (88%), consciousness and neurological dysfunction were improved to some extent. According to GCS, prognosis was good and recovery was good in 20 cases (56.6%), There were 9 cases (23.7%), 8 cases (21.1%) with severe disability, and 1 case (2.6%) with plant survival. There were no surgical deaths. Conclusion: Early skull repair and intraperitoneal peritoneal shunt can restore the physiological structure of the brain and significantly alleviate patient awareness and neurological dysfunction.