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腰大池腹腔分流术治疗交通性脑积水患者的治疗效果及安全性分析
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Abstract:
目的:分析可调压分流管腰大池腹腔分流术对交通性脑积水患者的治疗效果及安全性。方法:对烟台毓璜顶医院神经外科2019年10月至2021年4月的84例交通性脑积水患者进行回顾性研究。根据手术方式的不同将患者分为观察组(32例,可调压分流管腰大池腹腔分流术)与对照组(52例,可调压分流管脑室腹腔分流术)。使用卡方检验对比两组患者术后两周内临床症状改善及并发症发生情况的统计学差异。结果:两组患者术后在步态不稳、认知障碍及尿失禁等症状的改善方面无明显统计学差异。两组患者术后在发生分流管异常、感染、脑内出血及癫痫等并发症方面无明显统计学差异。结论:与可调压分流管脑室腹腔分流术相比,可调压分流管腰大池腹腔分流术在术后患者临床症状改善及并发症发生两方面未见明显差别。
Objective: to analyze the therapeutic effect and safety of lumbar cistern peritoneal shunt with ad-justable pressure shunt tube in patients with communicating hydrocephalus. Methods: 84 patients with communicating hydrocephalus in the Department of Neurosurgery of Yantai Yuhuangding hospital from October 2019 to April 2021 were studied retrospectively. According to the different operation methods, the patients were divided into observation group (32 cases, lumbar cistern per-itoneal shunt with adjustable pressure shunt) and control group (52 cases, ventriculoperitoneal shunt with adjustable pressure shunt). Chi-square test was used to compare the improvement of clinical symptoms and the incidence of complications between the two groups within two weeks af-ter operation. Results: there was no significant difference in the improvement of gait instability, cognitive impairment and urinary incontinence between the two groups. There was no significant difference in complications such as shunt tube abnormality, infection, intracerebral hemorrhage and epilepsy between the two groups. Conclusion: compared with the ventriculoperitoneal shunt with adjustable pressure shunt, the lumbar cisternal shunt with adjustable pressure shunt has no significant difference in the improvement of clinical symptoms and the occurrence of complications.
[1] | 刘飞, 程宏伟. 脑积水分类和治疗现况及进展[J]. 国际神经病学神经外科学杂志, 2014, 41(1): 50-53. |
[2] | 姚洁民, 梁承钢. 脑积水的研究进展[J]. 中国现代医生, 2007, 45(13): 141-144. |
[3] | 苑来生, 刘霄, 李智. 可调压分流管腰大池腹腔分流术治疗创伤后脑积水的疗效及安全性研究[J]. 现代医药卫生, 2019, 35(13): 2042-2044. |
[4] | 马百涛, 王任直, 魏俊吉. 特发性正常压力脑积水的外科治疗进展[J]. 基础医学与临床, 2016, 36(8): 1164-1167. |
[5] | 童威. 可调压分流管腰大池腹腔分流术治疗120例创伤后脑积水患者的临床效果观察[J]. 当代医学, 2019, 25(8): 147-149. |
[6] | Kazui, H., Miyajima, M., Mori, E. and Ishikawa, M. (2015) Lumboperitoneal Shunt Surgery for Idiopathic Normal Pressure Hydrocephalus (SINPHONI-2): An Open-Label Randomised Controlled Trial. The Lancet Neurology, 14, 585-594. |
[7] | 陈晓薇, 陈治军, 谢腾, 等. 腰大池腹腔分流术与脑室腹腔分流术治疗特发性正常压力脑积水的临床疗效及安全性研究[J]. 临床外科杂志, 2019, 27(1): 45-47. |
[8] | Kanazawa, R., Ishihara, S., Sato, S., Teramoto, A. and Kariyushi, N. (2011) Familiarization with Lumboperitoneal Shunt Using Some Technical Resources. World Neurosurgery, 76, 347-351. |
[9] | 吴俊波. 腰大池-腹腔分流术与侧脑室-腹腔分流术治疗交通性脑积水临床效果的对比研究[J]. 实用心脑肺血管病杂志, 2015, 23(3): 83-85. |
[10] | 郑一科, 方水桥, 戚进聪, 等. 侧脑室腹腔分流术与腰大池腹腔分流术治疗交通性脑积水的效果[J]. 中国现代药物应用, 2016, 10(17): 90-91. |
[11] | 陈昌, 吴章泽, 王一芳, 等. 可调压分流管腰大池腹腔分流术治疗创伤后脑积水的临床疗效及对远期预后的影响[J]. 中西医结合心脑血管病杂志, 2020, 18(21): 3688-3691. |