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脑室腹腔分流术对步态表现的影响。

The Effects of Ventriculoperitoneal Shunt on Gait Performance.

作者信息

Baltateanu Dumitru, Ciobanu Ileana, Berteanu Mihai

机构信息

Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

Elias University Emergency Hospital, Bucharest, Romania.

出版信息

J Med Life. 2019 Apr-Jun;12(2):194-198. doi: 10.25122/jml-2019-1004.

Abstract

Most studies on patients with normal pressure hydrocephalus (NPH) regard pre-post Tap test and long-term follow-up after shunt surgery. Quantitative and qualitative assessment tools specific to rehabilitation medicine can provide an objective measurement of the benefit of the neurosurgical intervention at 1-month follow-up. The aim of this retrospective study was to assess the early benefit of the ventriculoperitoneal shunt with low or medium pressure valve on the gait capacity of persons with NPH, one month after surgery. This is a retrospective study reviewing 19 inpatients with NPH who underwent neurosurgery for ventriculoperitoneal shunt with low or medium pressure valve, one month after a positive result on a tap test, in a 5-year period. The assessments regarding the gait abilities were performed 24 hours before the surgical intervention and one month after surgery. Assessment tools used were: the 3 meters Timed Up and Go Test (TUG), the 10 Meters Walking Test (10MWT) and the Berg Balance Scale. A positive response to the tap test predicted improvements of gait and balance in patients with NPH after shunt surgery. Best results in regards to gait and balance are achieved when early diagnosis and intervention are performed. Complex comorbidities generate and enhance significant and persistent gait impairment.

摘要

大多数关于正常压力脑积水(NPH)患者的研究都涉及术前术后的腰穿试验以及分流手术后的长期随访。康复医学特有的定量和定性评估工具能够在术后1个月时对神经外科干预的益处进行客观测量。这项回顾性研究的目的是评估术后1个月时,使用低压力或中压力阀门的脑室腹腔分流术对NPH患者步态能力的早期益处。这是一项回顾性研究,在5年期间,对19例接受了低压力或中压力阀门脑室腹腔分流术的NPH住院患者进行了研究,这些患者在腰穿试验结果为阳性1个月后接受了神经外科手术。在手术干预前24小时和术后1个月对步态能力进行评估。使用的评估工具包括:3米定时起立行走测试(TUG)、10米步行测试(10MWT)和伯格平衡量表。腰穿试验阳性预示着分流手术后NPH患者的步态和平衡会有所改善。早期诊断和干预可在步态和平衡方面取得最佳效果。复杂的合并症会导致并加重显著且持续的步态障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16d4/6713789/56be234cfd11/JMedLife-12-194-g001.jpg

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