Department of Emergency, An Nan Hospital, China Medical University, Tainan, 70965 Taiwan.
Graduate Institute of Medical Sciences, Chang Jung Christian University, Tainan, 71101 Taiwan.
Clin Interv Aging. 2023 Mar 23;18:477-483. doi: 10.2147/CIA.S401116. eCollection 2023.
This study aimed to evaluate the functional outcomes of lumboperitoneal (LP) shunt for the treatment of non-obstructive hydrocephalus.
We retrospectively studied the clinical surgical results of 172 adult patients with hydrocephalus who underwent LP shunt surgery between June 2014 and June 2019. Data regarding the following were collected: pre- and postoperative symptom status, third ventricle width changes, Evans index, and postoperative complications. Additionally, the baseline and follow-up Glasgow Coma Scale (GCS) score, Glasgow Outcome Scale (GOS), and Modified Rankin Scale (mRS) scores were investigated. All patients were followed up for ≥12 months using clinical interview and braining imaging using computed tomography (CT) scan or magnetic resonance imaging (MRI).
Majority of patients presented with normal pressure hydrocephalus as the etiology of their disease (48.8%), followed by cardiovascular accident (28.5%), trauma (19.7%), and brain tumor (3%). The mean GCS, GOS, and mRS improved postoperatively. The average period from symptomatic onset to surgery was 402 days. The average width of the third ventricle on CT scan or MRI was 11.43 mm preoperatively and 10.8 mm postoperatively (P<0.001). The Evans index improved from 0.258 to 0.222 after operation. The symptomatic improvement score was 7.0, with a complication rate of 7%.
Significant improvement was observed in the functional score and brain image after LP shunt placement. Moreover, the satisfaction with symptomatic improvement after surgery remains high. LP shunt operation is a viable alternative in the treatment of non-obstructive hydrocephalus due to the low complication rate, fast recovery, and high satisfaction.
本研究旨在评估腰腹腔（LP）分流术治疗非梗阻性脑积水的功能结局。
我们回顾性研究了 2014 年 6 月至 2019 年 6 月期间接受 LP 分流术治疗的 172 例成人脑积水患者的临床手术结果。收集的数据包括：术前和术后症状状态、第三脑室宽度变化、Evans 指数和术后并发症。此外，还研究了基线和随访时的格拉斯哥昏迷量表（GCS）评分、格拉斯哥结局量表（GOS）评分和改良 Rankin 量表（mRS）评分。所有患者均通过临床访谈和脑成像（CT 扫描或 MRI）进行了≥12 个月的随访。
大多数患者的疾病病因是正常压力脑积水（48.8%），其次是心血管意外（28.5%）、创伤（19.7%）和脑肿瘤（3%）。术后 GCS、GOS 和 mRS 平均均有所改善。从症状发作到手术的平均时间为 402 天。CT 扫描或 MRI 上第三脑室的平均宽度术前为 11.43mm，术后为 10.8mm（P<0.001）。Evans 指数从 0.258 改善至 0.222。症状改善评分为 7.0，并发症发生率为 7%。
LP 分流术后功能评分和脑图像均有显著改善。此外，患者对术后症状改善的满意度仍然很高。LP 分流术治疗非梗阻性脑积水的并发症发生率低、恢复快、满意度高，是一种可行的选择。
