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Prognostic and Risk Factors Analysis of 106 Patients Undergoing Ventriculoperitoneal Shunt Combined with Cranioplasty


 Background: The study is to summarize the therapeutic effect and long-term prognosis of ventriculoperitoneal shunt combined with cranioplasty, analyze the operation-related risk factors and common complications, and summarize the experience, so as to improve the safety of the operation.Methods: Retrospective analysis was performed on 106 patients diagnosed with post-operative skull loss with communicating hydrocephalus who underwent ventriculoperitoneal shunt combined with cranioplasty at our hospital. Age, gender, etiology, course of the disease, imaging manifestations, combined diseases, and prognosis of the patients were analyzed, as well as the risk factors and common complications of the operation.Results: Among the 106 patients, 62 were males, and 44 were females, with an age range from 17~67 years old. There were 72 cases of craniocerebral injury, 23 cases of hypertensive intracerebral hemorrhage, and 11 cases of intracranial aneurysm rupture. There were 84 patients with a course of disease ≤3 months during operation, and 22 patients with a course of disease > 3 months. There were 71 cases with GCS score ≤8, and 35 cases with GCS score > 8. There were 10 patients with skull base fracture and cerebrospinal fluid (CSF) rhinorrhea and 24 patients with severe hydrocephalus. Among the 106 patients, 79 showed improvement after the operation, 24 showed no significant improvement, and 3 underwent the second operation due to aggravated condition. Most of the patients with poor prognosis were patients with GCS score ≤8 points at the time of surgery, patients with previous skull base fracture and CSF rhinorrhea, patients with intraoperative hemorrhage > 800ml, and patients with post-operative body temperature over 39 °C. Conclusions: Our results revealed that ventriculoperitoneal shunt, combined with cranioplasty, is a useful approach. For patients with a high risk of operation, condition assessment, and monitoring should be strengthened. For patients with fever combined with infection or cerebral hemorrhage after the operation, active surgical treatment should be performed. Trial registration: Not applicable