特发性正常压力脑积水分流手术结局的系统评价。
Systematic review of the outcome of shunt surgery in idiopathic normal-pressure hydrocephalus.
机构信息
Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK,
出版信息
Acta Neurochir (Wien). 2013 Oct;155(10):1977-80. doi: 10.1007/s00701-013-1835-5. Epub 2013 Aug 23.
INTRODUCTION
Early surgical series of shunt insertion for idiopathic normal-pressure hydrocephalus reported a low rate of short-term improvement with a relatively high rate of mortality and morbidity; subsequently shunt insertion was recommended for patients in whom there is favourable risk-to-benefit ratio.
METHODS
Bibliographic search for studies that objectively assessed the outcome following shunt insertion in idiopathic normal-pressure hydrocephalus was done; the aim was to estimate the outcome of shunt insertion in terms of improvement rates and associated mortality and morbidity.
RESULTS
A total of 64 studies of 3,063 patients were reviewed. Positive improvement following shunt insertion was reported in an average of 71 % of patients with an average 1 % mortality. Results from studies published in the last 5 years showed 82 % improvement following shunt insertion, mortality of 0.2 %, and combined common complications rate of 8.2 %.
CONCLUSION
When patients are properly selected, shunt insertion is a safe and effective management of idiopathic normal-pressure hydrocephalus with a prolonged positive outcome.
简介
早期对特发性正常压力脑积水患者进行分流术的手术系列报告显示，短期改善率较低，死亡率和发病率相对较高；随后建议对风险效益比有利的患者进行分流术。
方法
对客观评估特发性正常压力脑积水患者分流术后结果的研究进行文献检索；目的是根据改善率以及相关死亡率和发病率来评估分流术的结果。
结果
共回顾了 64 项 3063 例患者的研究。平均有 71%的患者在分流术后有积极的改善，平均死亡率为 1%。最近 5 年发表的研究结果显示，分流术后的改善率为 82%，死亡率为 0.2%，常见并发症发生率为 8.2%。
结论
当患者得到适当选择时，分流术是一种安全有效的特发性正常压力脑积水的治疗方法，其长期效果为积极。
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