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非脑积水患者的腰-腹腔分流术。41例病例回顾。

Lumbo-peritoneal shunt in non-hydrocephalic patients. A review of 41 cases.

作者信息

Bret P, Huppert J, Massini B, Lapras C, Fischer G

出版信息

Acta Neurochir (Wien). 1986;80(3-4):90-2. doi: 10.1007/BF01812280.

Abstract

A population of 41 non-hydrocephalic patients in whom a lumbo-peritoneal shunt (LPS) was inserted for various conditions is reviewed. 19 had persistent cerebro-spinal fluid rhinorrhoea following cranial injury, basal skull surgery or of unknown origin, 3 had recalcitrant benign intra-cranial hypertension, 14 had a persistent bulging craniotomy site after operations for intra-cranial tumours or head trauma, 4 had syringomyelia and 1 had a postoperative cervical meningocele. There was no shunt-related mortality. LPS was effective in treating the initial symptomatology in 31 patients. Further revision or removal of LPS were needed on 9 occasions in 8 patients showing shunt-related mechanical or infectious complications or persistent postural headaches. This report demonstrates the safety of the LPS procedure experienced in another population of 146 patients with communicating hydrocephalus operated on in the meantime. According to the authors' experience, the versatility of the clinical applications of LPS seems well established. LPS should be considered when a CSF diversion is required in patients showing absent or minimal ventricular enlargement in the CT scan.

摘要

回顾了41例因各种情况接受腰大池-腹腔分流术(LPS)的非脑积水患者。19例在颅脑损伤、颅底手术或病因不明后出现持续性脑脊液鼻漏,3例患有顽固性良性颅内高压,14例在颅内肿瘤或头部外伤手术后颅骨切开部位持续膨隆,4例患有脊髓空洞症,1例患有术后颈段脊膜膨出。无分流相关死亡病例。LPS对31例患者的初始症状有效。8例患者因分流相关的机械性或感染性并发症或持续性体位性头痛,9次需要进一步翻修或移除LPS。本报告证明了同期接受手术的另一组146例交通性脑积水患者所经历的LPS手术的安全性。根据作者的经验,LPS临床应用的多功能性似乎已得到充分证实。对于CT扫描显示脑室扩大缺失或轻微的患者,在需要脑脊液分流时应考虑LPS。

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