Czosnyka Z, Czosnyka M, Richards H, Pickard J D
U.K. Shunt Evaluation Laboratory, Addenbrooke's Hospital, Cambridge, U.K.
Acta Neurochir Suppl. 1998;71:334-9. doi: 10.1007/978-3-7091-6475-4_97.
Hydrodynamic properties of hydrocephalus shunts are not always properly characterized by the manufacturer. Therefore, the choice of the shunt should be made, by matching performance of the shunt to the disturbed profile of CSF circulation of a given patient. The aim of the present shunt evaluation study is to evaluates all types of shunts presently in use in the U.K. and make this information available to neurosurgeons. Ten most common models of valves have been tested to date: Medtronik PS Medical: Delta Valve, Flow Control Valves and Lumbo-Peritoneal Shunt, Heyer-Schulte: In-line, Low Profile and Pudenz Flushing Valve, Codman: Medos-Programmable, Hakim-Precision, Sophy Programmable Valve, Cordis Orbis-Sigma. Our results show the majority of valves have low hydrodynamic resistance (exception: PS Lumboperitoneal, Orbis-Sigma), which increase by 100-200% after connection of a long distal catheter. A few shunts with siphon-preventing mechanism (Delta, Hayer-Schulte Low Profile, Pudenz-Flushing) offer reasonable resistance to negative outlet pressures, however, these valves may be blocked by raised subcutaneous pressure. All programmable valves are susceptible to siphoning. Programmed settings may be changed by external magnetic field.
脑积水分流器的流体动力学特性并非总能得到制造商的恰当描述。因此，应根据分流器的性能与特定患者脑脊液循环紊乱情况相匹配来选择分流器。本分流器评估研究的目的是评估目前在英国使用的所有类型的分流器，并将这些信息提供给神经外科医生。迄今为止，已对十种最常见的瓣膜型号进行了测试：美敦力PS医疗公司的Delta瓣膜、流量控制阀和腰大池-腹腔分流器；Heyer-Schulte公司的直列式、低剖面和Pudenz冲洗阀；Codman公司的Medos可编程、Hakim精密、Sophy可编程瓣膜；Cordis Orbis-Sigma。我们的结果表明，大多数瓣膜的流体动力学阻力较低（例外情况：PS腰大池-腹腔分流器、Orbis-Sigma），在连接长的远端导管后，阻力会增加100%至200%。一些具有防虹吸机制的分流器（Delta、Heyer-Schulte低剖面、Pudenz冲洗）对负的出口压力具有合理的阻力，然而，这些瓣膜可能会被升高的皮下压力阻塞。所有可编程瓣膜都容易发生虹吸现象。编程设置可能会因外部磁场而改变。
