[1]罗宝昌 黄书岚 刘华明.脑室-腹腔分流术治疗蛛网膜下腔出血后慢性脑积水的疗效分析[J].中国临床神经外科杂志,2017,(06):403-406.[doi:10.13798/j.issn.1009-153X.2017.06.012]
 LUO Bao-chang,HUANG Shu-lan,LIU Hua-ming..Analysis of curative effect of ventriculoperitoneal shunt with different shunt catheters on hydrocephalus after subarachnoid hemorrhage[J].,2017,(06):403-406.[doi:10.13798/j.issn.1009-153X.2017.06.012]
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脑室-腹腔分流术治疗蛛网膜下腔出血后慢性脑积水的疗效分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年06期
页码:
403-406
栏目:
论著
出版日期:
2017-06-25

文章信息/Info

Title:
Analysis of curative effect of ventriculoperitoneal shunt with different shunt catheters on hydrocephalus after subarachnoid hemorrhage
文章编号:
1009-153X(2017)06-0403-04
作者:
罗宝昌 黄书岚 刘华明
430060 武汉,武汉大学人民医院神经外科
通讯作者:黄书岚,E-mail:huang_shulan@msn.com
Author(s):
LUO Bao-chang HUANG Shu-lan LIU Hua-ming.
Department of Neurosurgery, Renmin Hospital, Wuhan University, Wuhan 430060, China
关键词:
蛛网膜下腔出血脑积水脑室-腹腔分流术疗效
Keywords:
Hydrocephalus Subarachnoid hemorrhage Ventriculoperitoneal shunt Adjustable pressure shunt catheters
分类号:
R 742.7; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2017.06.012
文献标志码:
A
摘要:
目的 探讨脑室-腹腔分流术(VPS)治疗蛛网膜下腔出血(SAH)后慢性脑积水的疗效。方法 2009年1月至2015年12月采用VPS治疗SAH后慢性脑积水56例,根据分流管类型分为定压组(32例)和可调压组(24例)。定压组采用美国Medtronic非可调压抗虹吸分流管套装,可调压组采用法国索菲萨可调压抗虹吸分流管套装。术后随访6~32个月,术后6个月采用日常生活能力量表(ADL)评分-术前ADL评分的差值评估疗效。结果 术前腰椎穿刺术测压>220 mmH2O 4例,140~220 mmH2O 38例,<140 mmH2O 14例,其中正常压力性脑积水44例,选择高压管3例,中压管24例,低压管5例,可调压分流管24例。可调压组术后发生堵管3例,感染2例,未发生分流不足、分流过度;定压组术后发生分流不足6例,分流过度4例,堵管8例,感染7例;可调压组术后并发症发生率(20.8%,5/24)明显低于定压组(78.1%,25/32;P<0.05)。术后6个月,可调压组ADL评分提高(29.9±1.75)分,定压组提高(25.1±1.34)分;可调压组明显优于定压组(P<0.05)。结论 VPS是治疗SAH后慢性脑积水的有效方法,应根据病人具体情况选择最适合分流压力的分流管以达到最佳手术效果,首选可调压分流管。
Abstract:
Objective To investigate the curative effects of ventriculoperitoneal shunt (VPS) with different shunt catheters on the chronic hydrocephalus after subarachnoid hemorrhage (SAH) and its complications. Methods The clinical data of 56 patients with chronic hydrocephalus after SAH, of whom, 24 patients (observed group) underwent VPS with adjustable pressure shunt catheters and 32 (control group) with unadjustable pressure shunt catheters, from January, 2009 to December, 2015, were analyzed retrospectively. The curative effects were compared between both the groups. Results The curative effect was significantly better in the observed group than that in the control group according to activities of daily living scale (P<0.05). The rates of occurrences of excessive and insufficient shunts were significantly lower in the observed group respectively than those in the control group (P<0.05). Conclusions The VPS with adjustable pressure shunt catheters is very helpful to the increase in the curative effect of VPS on chronic hydrocephalus after SAH and decrease in the complications after VPS.

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更新日期/Last Update: 2017-06-25