采用经皮腰腹腔分流术微创治疗交通性脑积水。
Minimally-invasive treatment of communicating hydrocephalus using a percutaneous lumboperitoneal shunt.
机构信息
Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, China.
出版信息
J Zhejiang Univ Sci B. 2011 Apr;12(4):293-7. doi: 10.1631/jzus.B1000248.
OBJECTIVE
To investigate the clinical value of a minimally-invasive treatment of communicating hydrocephalus using a percutaneous lumboperitoneal (LP) shunt.
METHOD
The clinical and long-term follow-up data of 256 patients suffering from communicating hydrocephalus and undergoing percutaneous LP shunt during 1998 to 2008 were retrospectively analyzed.
RESULTS
After the follow-up, which lasted 6 months to 10 years, 219 cases of communicating hydrocephalus recovered well (ventricular size returned to normal and symptoms completely disappeared), 25 cases were brought under control (ventricle size reduced by 50% and symptoms partially abated), and 12 cases showed no obvious changes. Fifteen obese subjects needed modifications of the shunt due to the obstruction of the abdominal end following wrapping, and one subject underwent extubation as the subject was unable to tolerate stimulation of the cauda equina. The effectiveness of shunting was 91.40% and the probability of shunt-tube obstruction, which occurs predominantly in the abdominal end, was only 5.85%, far lower than that of ventriculoperitoneal (VP) shunt. Three subjects had a history of infection following VP shunting.
CONCLUSION
LP shunting is minimally invasive and effective in treating communicating hydrocephalus, with fewer complications.
目的
探讨经皮腰大池-腹腔分流术治疗交通性脑积水的临床价值。
方法
回顾性分析 1998 年至 2008 年 256 例交通性脑积水患者行经皮腰大池-腹腔分流术的临床及长期随访资料。
结果
随访 6 个月至 10 年，219 例交通性脑积水患者恢复良好（脑室大小恢复正常，症状完全消失），25 例得到控制（脑室大小缩小 50%，症状部分缓解），12 例无明显变化。15 例肥胖患者因腹部包裹导致腹腔端堵塞需要修改分流管，1 例因不能耐受马尾刺激而拔管。分流有效率为 91.40%，而以腹部端为主的分流管阻塞发生率仅为 5.85%，远低于脑室-腹腔分流术。3 例患者有 VP 分流术后感染史。
结论
LP 分流术治疗交通性脑积水微创有效，并发症少。
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