Sun Tong, Chen Siyang, Wang Junjie, You Chao, Wu Ke
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Health Management Center, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Sci Rep. 2025 Jan 2;15(1):500. doi: 10.1038/s41598-024-84158-w.
Hydrocephalus, whether arising from post-hemorrhagic or post-traumatic origins, poses significant challenges in clinical management. Lumboperitoneal shunting (LPS) emerges as a viable therapeutic intervention, yet comparative analyses between these etiologies remain scarce. This retrospective study aims to compare the efficacy and safety of LPS placement in patients with post-hemorrhagic (PHH) and post-traumatic hydrocephalus (PTH). This retrospective study investigates shunting outcomes in patients aged 18 years or older diagnosed with PHH or PTH who underwent LPS between 2014 and 2018. Primary outcomes included shunt reoperation rates, with secondary outcomes encompassing modified Rankin Scale (mRS) and National Institute of Health Stroke Scale (NIHSS) scores, Evans index, complications, and length of hospital stay. Favorable outcomes were defined as an mRS score of 2 or less. A total of 34 PHH and 48 PTH patients were included, with baseline characteristics being similar between groups. Shunt reoperation rates were comparable between PHH (23.5%) and PTH (27.1%) groups (P = 0.716). At 2 years, favorable outcomes were observed in 82.4% of PHH patients and 72.9% of PTH patients (P = 0.318). NIHSS scores at discharge (P = 0.230) and at 2 years (P = 0.530) showed no significant differences. However, PHH patients exhibited shorter hospital stays post-LPS implantation (P = 0.025). LPS placement demonstrates comparable outcomes in patients with PHH and PTH, with similar rates of shunt reoperation and complications, as well as equivalent neurological outcomes. However, Notably, PTH patients exhibited a higher risk of shunt malfunction compared to PHH patients, along with prolonged hospital stays post-LPS implantation.
脑积水,无论源于出血后还是创伤后,在临床管理中都带来了重大挑战。腰大池腹腔分流术(LPS)成为一种可行的治疗干预措施,但这些病因之间的比较分析仍然很少。这项回顾性研究旨在比较LPS植入术在出血后脑积水(PHH)和创伤后脑积水(PTH)患者中的疗效和安全性。这项回顾性研究调查了2014年至2018年间接受LPS治疗的18岁及以上诊断为PHH或PTH的患者的分流结果。主要结局包括分流再次手术率,次要结局包括改良Rankin量表(mRS)和美国国立卫生研究院卒中量表(NIHSS)评分、Evans指数、并发症和住院时间。良好结局定义为mRS评分为2或更低。总共纳入了34例PHH患者和48例PTH患者,两组之间的基线特征相似。PHH组(23.5%)和PTH组(27.1%)的分流再次手术率相当(P = 0.716)。在2年时,82.4%的PHH患者和72.9%的PTH患者观察到良好结局(P = 0.318)。出院时(P = 0.230)和2年时(P = 0.530)的NIHSS评分无显著差异。然而,PHH患者在LPS植入术后的住院时间较短(P = 0.025)。LPS植入术在PHH和PTH患者中显示出相当的结局,分流再次手术率和并发症发生率相似,神经学结局相当。然而,值得注意的是,与PHH患者相比,PTH患者的分流功能障碍风险更高,并且在LPS植入术后住院时间更长。