Department of Neurological Surgery, University of California at San Francisco, 505 Parnassus Avenue, San Francisco, Califonia 94143, USA.
J Clin Neurosci. 2011 May;18(5):649-54. doi: 10.1016/j.jocn.2010.08.028. Epub 2011 Mar 2.
The goal of this study was to characterize long-term social and functional outcomes in adults treated for idiopathic normal pressure hydrocephalus (NPH). Data for 252 patients treated medically or surgically for idiopathic NPH were obtained through the Hydrocephalus Association Database Project. Data on post-surgical outcomes including improvement in symptoms, the need for in-home care, ability to drive, and employment status were analyzed. Most patients (73.7%) surveyed were treated with a shunt, an endoscopic third ventriculostomy (ETV), or both. More patients who underwent surgery reported driving and being employed compared to those who did not have surgery. Most shunt patients had improvements in gait (81.1%), urinary incontinence (55.9%), and dementia (64.4%). Overall, shunt patients reported more dramatic improvements in quality of life as compared to ETV patients (72.2% versus 55.6%). Treating idiopathic NPH with cerebrospinal fluid diversion facilitates a return to independence through improved functional and social outcomes.
本研究旨在描述特发性正常压力脑积水(NPH)患者经治疗后的长期社会和功能结局。通过脑积水协会数据库项目获取了 252 例特发性 NPH 患者经药物或手术治疗的数据。分析了术后结局的数据,包括症状改善、家庭护理需求、驾驶能力和就业状况。大多数接受调查的患者(73.7%)接受了分流术、内镜第三脑室造瘘术(ETV)或两者的联合治疗。与未接受手术的患者相比,接受手术的患者更有可能报告自己能够驾驶和就业。大多数分流术患者的步态(81.1%)、尿失禁(55.9%)和痴呆(64.4%)得到改善。总体而言,与 ETV 患者相比(72.2%与 55.6%),分流术患者的生活质量改善更为显著。通过脑脊液分流治疗特发性 NPH 可改善功能和社会结局,促进患者恢复独立。