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使用串联分流阀系统控制脑脊液流动和颅内压的新方法。

Novel method for controlling cerebrospinal fluid flow and intracranial pressure by use of a tandem shunt valve system.

作者信息

Aihara Yasuo, Kawamata Takakazu, Mitsuyama Tetsuryu, Hori Tomokatsu, Okada Yoshikazu

机构信息

Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.

出版信息

Pediatr Neurosurg. 2010;46(1):12-8. doi: 10.1159/000314052. Epub 2010 May 5.

DOI:10.1159/000314052
PMID:20453558
Abstract

OBJECTIVE

Programmable shunt valve systems have improved the management of patients with hydrocephalus. However, associated problems such as over-drainage and slit-like ventricles, even in patients with anti-siphon devices installed, still remain unresolved.

METHODS

We conceived a novel tandem shunt valve system to overcome the problems with existing shunt valve systems. Experiments were performed in vitro and a manometer was used to measure the results.

RESULTS

Manometric measurements in vitro with the tandem shunt valve system demonstrated that it effectively controlled the final pressure under varying flow rates. This novel system was applied to 2 intractable cases (over-drainage and slit-like ventricles) with good results.

INTERPRETATION

The tandem shunt valve system has therapeutic potential not only for over-drainage and slit-like ventricles, but also for uncontrollable hydrocephalus, by precisely controlling the cerebral spinal fluid flow rate.

摘要

目的

可编程分流阀系统改善了脑积水患者的治疗管理。然而,即使在安装了抗虹吸装置的患者中,诸如过度引流和裂隙样脑室等相关问题仍未得到解决。

方法

我们构思了一种新型串联分流阀系统,以克服现有分流阀系统存在的问题。进行了体外实验,并使用压力计测量结果。

结果

串联分流阀系统的体外压力测量表明,它能在不同流速下有效控制最终压力。这种新型系统应用于2例难治性病例(过度引流和裂隙样脑室),效果良好。

解读

串联分流阀系统通过精确控制脑脊液流速,不仅对过度引流和裂隙样脑室具有治疗潜力,而且对难以控制的脑积水也具有治疗潜力。

相似文献

1
Novel method for controlling cerebrospinal fluid flow and intracranial pressure by use of a tandem shunt valve system.使用串联分流阀系统控制脑脊液流动和颅内压的新方法。
Pediatr Neurosurg. 2010;46(1):12-8. doi: 10.1159/000314052. Epub 2010 May 5.
2
In vitro experiment for verification of the tandem shunt valve system: a novel method for treating hydrocephalus by flexibly controlling cerebrospinal fluid flow and intracranial pressure.串联分流阀系统的体外验证实验:一种通过灵活控制脑脊液流动和颅内压来治疗脑积水的新方法。
J Neurosurg Pediatr. 2013 Jan;11(1):43-7. doi: 10.3171/2012.10.PEDS12226. Epub 2012 Nov 9.
3
[The management of slit-like ventricle with the Medos programmable Hakim valve and the ventriculofiberscope].[使用Medos可编程Hakim瓣膜和脑室纤维内镜治疗裂隙样脑室]
No Shinkei Geka. 1998 Apr;26(4):349-56.
4
The programmable adult Codman Hakim valve is useful even in very small children with hydrocephalus. A 7-year retrospective study with special focus on cost/benefit analysis.可编程的成人Codman Hakim瓣膜即使在患有脑积水的非常小的儿童中也很有用。一项为期7年的回顾性研究,特别关注成本效益分析。
Eur J Pediatr Surg. 2006 Feb;16(1):1-7. doi: 10.1055/s-2006-923904.
5
[Effect of the anti-siphon device (ASD) on the function of various hydrocephalus drainage systems in the child].
Z Kinderchir. 1986 Dec;41(6):327-34. doi: 10.1055/s-2008-1043370.
6
Laboratory testing of hydrocephalus shunts -- conclusion of the U.K. Shunt evaluation programme.脑积水分流器的实验室检测——英国分流器评估项目的结论
Acta Neurochir (Wien). 2002 Jun;144(6):525-38; discussion 538. doi: 10.1007/s00701-002-0922-9.
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Posture-independent piston valve: a novel valve mechanism that actuates based on intracranial pressure alone.姿势无关型活塞阀:一种仅基于颅内压启动的新型阀机制。
J Neurosurg Pediatr. 2012 Jan;9(1):64-8. doi: 10.3171/2011.10.PEDS1182.
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Prevention of ventricular catheter obstruction and slit ventricle syndrome by the prophylactic use of the Integra antisiphon device in shunt therapy for pediatric hypertensive hydrocephalus: a 25-year follow-up study.在小儿高血压性脑积水分流治疗中预防性使用Integra抗虹吸装置预防脑室导管阻塞和裂隙脑室综合征:一项25年的随访研究
J Neurosurg Pediatr. 2010 Jan;5(1):4-16. doi: 10.3171/2008.7.17690.
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[Shunting operation with the medos programmable valve shunt system].[使用美敦力可编程分流系统进行分流手术]
No Shinkei Geka. 1994 Aug;22(8):731-5.
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Comparison of programmable shunt valves vs standard valves for communicating hydrocephalus of adults: a retrospective analysis of 407 patients.成人交通性脑积水的可编程分流阀与标准分流阀的比较:407例患者的回顾性分析
Surg Neurol. 2005 Jan;63(1):36-41; discussion 41. doi: 10.1016/j.surneu.2004.03.015.

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1
Dural sac shrinkage signs on spinal magnetic resonance imaging indicate overdrainage after lumboperitoneal shunt for idiopathic normal pressure hydrocephalus.脊髓磁共振成像上的硬膜囊收缩征提示特发性正常压力脑积水行腰大池腹腔分流术后引流过度。
Surg Neurol Int. 2022 Jun 23;13:269. doi: 10.25259/SNI_291_2022. eCollection 2022.
2
Increased CSF osmolarity reversibly induces hydrocephalus in the normal rat brain.脑脊液渗透压升高可使正常大鼠脑可逆性地发生脑积水。
Fluids Barriers CNS. 2012 Jul 11;9(1):13. doi: 10.1186/2045-8118-9-13.
3
The hydrokinetic parameters of shunts for hydrocephalus might be inadequate.
用于脑积水的分流器的流体动力学参数可能不足。
Surg Neurol Int. 2012;3:40. doi: 10.4103/2152-7806.94292. Epub 2012 Mar 24.