Yoshiyama Kenji, Kazui Hiroaki, Takeda Masatoshi
Department of Psychiatry, Osaka University Graduate School of Medicine.
Brain Nerve. 2015 Sep;67(9):1139-45. doi: 10.11477/mf.1416200273.
We used a questionnaire to evaluate how patients with idiopathic normal-pressure hydrocephalus (iNPH) are examined in Medical Centers for Dementia (MCDs), which are qualified medical organizations for dementia patients in Japan. Ninety-eight of 205 MCDs responded to our questionnaire. Accordingly, more than 590 patients with iNPH underwent an MCD examination during the period of 1 year. In regards to the Guidelines for Management of iNPH, 40 of the 98 MCDs used neither the first nor second edition of the Guidelines, even though up-to-date information is available in the second edition of the Guidelines. At most MCDs, consultation with iNPH specialists was performed without a cerebrospinal fluid tap test. At more than half of the responding MCDs, doctors felt that the selection of appropriate candidates for shunt surgery differed from those selected by neurosurgeons. Moreover, 73 out of 87 MCDs argued that patients with iNPH should be examined by both dementia specialists and neurosurgeons after shunt surgery. These results suggest that doctors at MCDs should take advantage of up-to-date information and cooperate with iNPH specialists and neurosurgeons.
我们使用一份调查问卷来评估在日本痴呆症患者的合格医疗机构——痴呆症医疗中心（MCDs）中，特发性正常压力脑积水（iNPH）患者是如何接受检查的。205家MCDs中有98家回复了我们的调查问卷。因此，在1年的时间里，超过590例iNPH患者接受了MCDs的检查。关于iNPH管理指南，98家MCDs中有40家既未使用第一版也未使用第二版指南，尽管第二版指南中有最新信息。在大多数MCDs中，与iNPH专家的会诊是在未进行脑脊液穿刺试验的情况下进行的。在超过一半回复的MCDs中，医生认为分流手术合适候选人的选择与神经外科医生所选的不同。此外，87家MCDs中有73家认为iNPH患者在分流手术后应由痴呆症专家和神经外科医生共同检查。这些结果表明，MCDs的医生应利用最新信息，并与iNPH专家和神经外科医生合作。
