Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
Department of Neurosurgery, Xichang Peoples' Hospital, Liangshan, Sichuan, PR China.
Medicine (Baltimore). 2021 Aug 6;100(31):e26691. doi: 10.1097/MD.0000000000026691.
Ventriculoperitoneal shunt (VPS) and lumboperitoneal shunt (LPS) remain the mainstay of idiopathic normal pressure hydrocephalus (INPH). There are no randomized controlled trials completed to compare the efficacy of these 2 shunt techniques.
METHODS/DESIGN: We will conduct a monocentric, assessor-blinded, and randomized controlled trial titled "Comparison of Ventriculoperitoneal Shunt to Lumboperitoneal Shunt for the treatment of Idiopathic Normal Pressure Hydrocephalus: Phase I (COVLINPH-1)" trial and recruit patients at West China Hospital of Sichuan University since June 2021. And this trial is expected to end in December 2030. Eligible participants will be randomly assigned into LPS group and VPS group at ratio of 1:1 followed by evaluation before surgery, 1 month, 12 months, and 5 years after surgery. The primary outcome is the rate of shunt failure within 5 years. The secondary outcomes include modified Rankin Scale (mRS), INPH grading scale (INPHGS), mini-mental state examination (MMSE), and Evans index. We will calculate the rate of favorable outcome, which is defined as shunt success and an improvement of more than 1 point in the mRS at evaluation point. We will also analyze the complications throughout the study within 5 years after shunt insertion.
The results of this trial will provide state-of-the-art evidence on the treatment option for patients with INPH, and will also generate the discussion regarding this subject.
ChiCTR2000031555; Pre-results.
脑室-腹腔分流术(VPS)和腰-腹腔分流术(LPS)仍然是特发性正常压力脑积水(INPH)的主要治疗方法。目前还没有完成比较这两种分流技术疗效的随机对照试验。
方法/设计:我们将开展一项单中心、评估者设盲、随机对照试验,题为“脑室-腹腔分流术与腰-腹腔分流术治疗特发性正常压力脑积水的比较:第 I 期(COVLINPH-1)”试验,并于 2021 年 6 月开始在四川大学华西医院招募患者。该试验预计于 2030 年 12 月结束。符合条件的参与者将以 1:1 的比例随机分配到 LPS 组和 VPS 组,随后在术前、术后 1 个月、12 个月和 5 年进行评估。主要结局是 5 年内分流失败的发生率。次要结局包括改良 Rankin 量表(mRS)、INPH 分级量表(INPHGS)、简易精神状态检查(MMSE)和 Evans 指数。我们将计算有利结局的发生率,定义为分流成功和 mRS 评分在评估点提高 1 分以上。我们还将分析分流后 5 年内的所有并发症。
该试验的结果将为 INPH 患者的治疗选择提供最新的证据,并将引发关于该主题的讨论。
ChiCTR2000031555;预结果。