本文選題：腦積水　切入點：顱骨缺損　出處：《中國醫藥導報》2016年35期

【摘要】：目的比較分析腦積水合并顱骨缺損同期手術與分期手術的效果。方法選擇2012年2月~2014年1月廣西壯族自治區江濱醫院收治的54例腦積水合并顱骨缺損患者,根據隨機數字表法將其隨機分為同期手術組(27例)和分期手術組(27例),同期手術組同期行腦室-腹腔分流術和顱骨修補術,分期手術組在腦室-腹腔分流術后4周~7個月后行顱骨修補術,比較兩組患者分流效果、神經功能恢復情況、并發癥發生率、生活質量、醫療費用、再次手術情況。結果兩組分流效果比較差異無統計學意義(P0.05);同期手術組神經功能恢復的優良率顯著高于分期手術組,差異有統計學意義(P0.05);同期手術組并發癥發生率為11.11%,分期手術組為29.63%,兩組比較差異無統計學意義(P0.05);同期手術組健康調查簡表(SF-36)中的心理健康和總體健康評分均顯著高于分期手術組(P0.05);同期手術組的醫療費用顯著低于分期手術組(P0.05);兩組均有1例患者行再次手術。結論雖然同期行腦室-腹腔分流術和顱骨修補術在腦積水合并顱骨缺損中的分流效果與分期手術無異,但它在神經功能恢復、并發癥、患者心理健康和醫療費用上更具優勢,值得臨床優先考慮使用。
[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.
【作者單位】： 廣西壯族自治區江濱醫院神經外科;
【分類號】：R651.1

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