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腰腹分流术:409例病例回顾

Lumboperitoneal shunts: review of 409 cases.

作者信息

Yadav Y R, Pande Sanjay, Raina Vijay K, Singh Manish

机构信息

Department of Surgery, Netaji Subhash Chandra Bose Medical College, Jabalpur, India.

出版信息

Neurol India. 2004 Jun;52(2):188-90.

Abstract

BACKGROUND AND AIMS

A prospective study was carried out to evaluate the lumboperitoneal shunt procedure.

MATERIAL AND METHODS

Four hundred and nine patients having communicating hydrocephalus were selected for the procedure during a 10-year period from March 1992 to February 2002. The average follow-up was 45.34 months.

RESULTS

Tubercular meningitis (TBM)-related hydrocephalus was detected in 285 patients. Forty per cent of the patients were less than 15 years of age. Glasgow Coma Scale (GCS) of less than 8 was seen in 40% patients and 14.9% patients were in GCS 13-15. At the time of discharge 56.7% patients improved in their GCS to 13 -15 and 14.9% were in GCS 8 or less. The overall mortality was 5.13% and shunt-related mortality was seen in 2% patients. Shunt malfunction requiring revision was seen in 32 patients (7.8%) and the total number of shunt revisions was 44 (11%). Shunt infection was noted in 3.4% patients. CSF leak at the lumbar end occurred in 12 patients. Four patients required conversion of LP shunt to VP shunt.

CONCLUSIONS

Lumboperitoneal shunt is an effective shunting procedure in communicating hydrocephalus.

摘要

背景与目的

开展一项前瞻性研究以评估腰大池腹腔分流术。

材料与方法

选取1992年3月至2002年2月这10年间的409例交通性脑积水患者进行该手术。平均随访时间为45.34个月。

结果

285例患者检测出结核性脑膜炎(TBM)相关脑积水。40%的患者年龄小于15岁。40%的患者格拉斯哥昏迷量表(GCS)评分低于8分,14.9%的患者GCS评分为13 - 15分。出院时,56.7%的患者GCS评分改善至13 - 15分,14.9%的患者GCS评分在8分及以下。总死亡率为5.13%,2%的患者出现分流相关死亡。32例患者(7.8%)出现需要翻修的分流故障,分流翻修总数为44次(11%)。3.4%的患者出现分流感染。12例患者在腰端出现脑脊液漏。4例患者需要将腰大池腹腔分流术转换为脑室腹腔分流术。

结论

腰大池腹腔分流术是治疗交通性脑积水的一种有效分流手术。

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