袁红刚

【摘要】 目的：分析脑积水合并颅骨缺损行分期手术与同期手术的临床效果、神经功能及生活质量。方法：选取笔者所在医院2015年

1月-2016年3月收治的88例脑积水合并颅骨缺损患者资料，根据手术时间不同可分两组，行同期手术的44例患者为研究组，行分期手术的44例患者为对照组。对比两组患者的神经功能、生存质量及并发症。结果：术后3、6个月，研究组神经功能评分均低于对照组，生存质量评分均高于对照组，并发症总发生率（22.72%）低于对照组的88.63%，差异均有统计学意义（t=2.060 2、3.986 0、5.842 9、7.513 0、3.492 4、6.167 7，字2=38.727 4，P<0.05）。结论：脑积水伴颅骨缺损患者同期行颅骨修补术与脑室腹腔分流术医治，可改善神经功能缺损，减少并发症，提高生存质量。

【关键词】 脑积水； 分期手术； 同期手术； 颅骨缺损

doi：10.14033/j.cnki.cfmr.2018.7.016 文獻标识码 B 文章编号 1674-6805（2018）07-0036-02

【Abstract】 Objective：To analyze the clinical effect，nerve function and quality of life of the patients with hydrocephalus combined with cranial defect by staging operation and homochronous operation.Method：A total of 88 patients with hydrocephalus and skull defect data were selected in our hospital from January 2015 to March 2016.On the basis of different operation time the patients were divided into two groups.44 patients who performed the homochronous operation were studied in the study group，and 44 patients with the staging operation were the control group.Compared two groups of neurological function，quality of survival and complications.Result：At 3，6 months after operation，the neurological function score points in the study group was lower than that in the control group，the quality of life scores were higher than those in the control group，the total incidence of complications was 22.72%，lower than 88.63% in the control group.The differences were statistically significant（t=2.060 2，3.986 0，5.842 9，7.513 0，3.492 4，6.167 7，

字2=38.727 4，P<0.05）.Conclusion：The treatment of cranioplasty and ventriculoperitoneal shunt in same term for hydrocephalus and skull defect patients，can improve neurological function，reduce complications and improve quality of life.

【Key words】 Hydrocephalus； Staging surgery； Homochronous operation； Skull defect

First-authors address：The peoples Hospital of Hanchuan，Hanchuan 431600，China

脑积水伴颅骨缺损病症可由颅骨切除或手术减压后继发导致，也可由脑外伤直接引起，患病率占神经外科的30%，可对患者身体健康产生极大影响，因而有效处理该病对疾病预后具有积极意义[1]。为此笔者所在医院将近期收治的88例脑积水并颅骨缺损患者作为研究对象，旨在分析分期手术与同期手术的疗效，现报道如下。

1 资料与方法

1.1 一般资料

选取笔者所在医院2015年1月-2016年3月收治的88例脑积水并颅骨缺损患者临床资料，所选患者均无血液疾病、甲状腺疾病、高血钾、传染性疾病，且签署知情同意书。排除发生第三脑室圆钝、脑室增大、神经功能受损及沟通障碍、肝肾功能不全、依从性差的患者。……