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脑室腹腔分流术后迟发性脑出血的特征

Characteristics of delayed intracerebral hemorrhage after ventriculoperitoneal shunt insertion.

作者信息

Gong Weiyi, Xu Li, Yang Peng, Yu Zhengquan, Wang Zhong, Chen Gang, Zhang Shiming, Wu Jiang

机构信息

Department of Neurosurgery, The First People's Hospital of Kunshan, Suzhou, Jiangsu Province, 215300, China.

Department of Intensive Care Unit, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, 215006, China.

出版信息

Oncotarget. 2017 Jun 27;8(26):42693-42699. doi: 10.18632/oncotarget.17444.

Abstract

BACKGROUND

Delayed intracerebral hemorrhage after ventriculoperitoneal (VP) shunt insertion is rare and has not been well investigated previously. Its characteristics is still unknown.

OBJECTIVE

We reported 12 patients with delayed intracerebral hemorrhage after VP shunt to investigate the potential risk factors and the outcome.

RESULTS

12 patients (1.59%) of all the 754 hydrocephalus had delayed intracerebral hemorrhage after VP shunt insertion. 4 patients were women and 8 patients were men, ranging in age from 50 to 76 years. The delayed cerebral hemorrhage from day 3 to day 7 post operation was diagnosed by repeated CT. The delayed intracerebral hemorrhage was significantly related to age, prior craniotomy operation history and manipulation of valve system (3-7 days). Neither gender sexuality nor potential risk factors for postoperative hemorrhage (including anticoagulation/antiplatelet status, liver disease, diabetes, hypertension), time of shunt attempt affected the happen of delayed intracerebral hemorrhage.

MATERIALS AND METHODS

The clinical characteristics including sex, age, anticoagulation/antiplatelet status, liver disease, diabetes, hypertension, craniotomy operation history, manipulation of valve system and time of shunt attempt of 754 patients who were surgically treated of VP shunt at the first affiliated hospital of Soochow University between 2007 and 2013 were reviewed retrospectively. The potential risk factors of the delayed intracerebral hemorrhage were statistically analyzed.

CONCLUSIONS

This study summarizes the presentation and outcome of a series of 12 patients with delayed intracerebral hemorrhage after VP shunt. Age ≥ 60 years, prior craniotomy operation and manipulation of the valve system are statistically significant to the delayed hematoma secondary to VP shunt.

摘要

背景

脑室腹腔(VP)分流术后迟发性脑出血较为罕见,此前尚未得到充分研究。其特征仍不明确。

目的

我们报告12例VP分流术后迟发性脑出血患者,以探讨潜在危险因素及预后情况。

结果

在754例脑积水患者中,有12例(1.59%)在VP分流术后发生迟发性脑出血。其中女性4例,男性8例,年龄在50至76岁之间。术后第3天至第7天通过重复CT检查诊断出迟发性脑出血。迟发性脑出血与年龄、既往开颅手术史及瓣膜系统操作(3至7天)显著相关。性别及术后出血的潜在危险因素(包括抗凝/抗血小板状态、肝病、糖尿病、高血压)、分流尝试时间均不影响迟发性脑出血的发生。

材料与方法

回顾性分析2007年至2013年在苏州大学附属第一医院接受VP分流手术治疗的754例患者的临床特征,包括性别、年龄、抗凝/抗血小板状态、肝病、糖尿病、高血压、开颅手术史、瓣膜系统操作及分流尝试时间。对迟发性脑出血的潜在危险因素进行统计学分析。

结论

本研究总结了12例VP分流术后迟发性脑出血患者的临床表现及预后情况。年龄≥60岁、既往开颅手术及瓣膜系统操作对VP分流术后迟发性血肿具有统计学意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/784a/5522098/bcf8d752675a/oncotarget-08-42693-g001.jpg

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