可调压腰大池-腹腔分流术治疗对外伤性脑积水预后的影响
|
摘要
目的探讨ALCPS治疗对TH患者预后的影响。方法选取2014年3月至2017年3月我院收治的TH患者100例,依据随机数字表法分为ALCPS组和VPS组,ALCPS组给予ALCPS治疗,VPS组给予VPS治疗,比较两组治疗疗效、并发症、ADL得分和NSE、S100β水平。结果 ALCPS组术后血清NSE、S100β水平明显低于VPS组,差异有统计学意义(P <0. 05); ALCPS组治疗有效率明显高于VPS组,差异有统计学意义(P <0. 05); ALCPS组并发症发生率明显低于VPS组,差异有统计学意义(P <0. 05); ALCPS组术后3、6个月ADL得分明显高于PS组,差异有统计学意义(P <0. 05)。结论 ALCPS治疗可有效降低TH患者血清NSE、S100β水平及并发症发生风险,可有效提高患者的治疗疗效和生活质量,有利于改善患者的预后,值得临床作进一步推广。
Objective The effect of ALCPS on prognosis of TH was studied. Methods A total of 100 patients with TH admitted to our hospital from March 2014 and March 2017 were selected randomly,and all the patients were divided into ALCPS group(50 cases) and VPS(50 cases). ALCPS group was treated with ALCPS and VPS group was treated with VPS,respectively. The efficacy,complications,ADL score,NSE and S100β levels were compared between two groups. Results Serum NSE,S100β levels in ALCPS group after surgery were significantly lower than those before surgery,with statistically significant difference(P < 0. 05). The effective rate of ALCPS group was significantly higher than that of VPS group,with statistically significant difference(P <0. 05). The complication rate of ALCPS group was significantly lower than that of VPS group,with statistically significant difference(P < 0. 05).ADL scores of ALCPS group at 3 months and 6 months after operation were significantly lower than those before operation,and the difference was statistically significant(P <0. 05). Conclusion ALCPS treatment can effectively reduce the serum NSE,S100 beta levels and the risk of complications in patients with TH,and it is beneficial to improve the prognosis of the patients. So it's worth of further clinical promotion.
Objective The effect of ALCPS on prognosis of TH was studied. Methods A total of 100 patients with TH admitted to our hospital from March 2014 and March 2017 were selected randomly,and all the patients were divided into ALCPS group(50 cases) and VPS(50 cases). ALCPS group was treated with ALCPS and VPS group was treated with VPS,respectively. The efficacy,complications,ADL score,NSE and S100β levels were compared between two groups. Results Serum NSE,S100β levels in ALCPS group after surgery were significantly lower than those before surgery,with statistically significant difference(P < 0. 05). The effective rate of ALCPS group was significantly higher than that of VPS group,with statistically significant difference(P <0. 05). The complication rate of ALCPS group was significantly lower than that of VPS group,with statistically significant difference(P < 0. 05).ADL scores of ALCPS group at 3 months and 6 months after operation were significantly lower than those before operation,and the difference was statistically significant(P <0. 05). Conclusion ALCPS treatment can effectively reduce the serum NSE,S100 beta levels and the risk of complications in patients with TH,and it is beneficial to improve the prognosis of the patients. So it's worth of further clinical promotion.
引文
1余定庸,唐晓平,彭华,等.外伤性颅骨缺损并脑积水同期手术治疗分析[J].中国综合临床,2011,27(4):424-425.
2 刘瑞,梁广榆,高亚飞.脑室腹腔分流术治疗外伤性脑积水中分流管的选择[J].临床医学研究与实践,2016,1(23):94-95.
3 ANDREASEN T H,HOIST A V,LILJA A,et al. Valved or valveless ventriculoperitoneal shunting in the treatment of post-haemorrhagic hydrocephalus:a population-based consecutive cohort study[J]. Acta Neurochirurgica(Wien),2016,158(2):261-270.
4 黄程.分期脑室-腹腔分流术及颅骨修补术治疗外伤性脑积水合并颅骨缺损患者的临床效果[J].实用临床医药杂志,2016,20(13):94-95.
5 鲁军体,王娜,刘炎伟,等.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患者的效果比较[J].检验医学与临床,2017,14(10):1429-1433.
6 ZHANG Y,ZHU X,ZHAO J,et al. Ventriculoperitoneal shunting surgery with open distal shunt catheter placement in the treatment of hydrocephalus[J]. Celt Biochem Biophys,2015,73(2):533-536.
7 ZHANG Y H,ZHANG C H,HU Z M,et al. Pancreatic cancer:open or minimally invasive surgery and the effects of minimally invasive removal of intracerebral hematoma on perihematomal matrix metalloproteinase[J]. World J Gastroenterol,2016,22(32):7301-7310.
8 李旭.不同分流方式在正常颅内压脑积水患者中的临床效果观察[J].国际医药卫生导报,2017,23(2):190-192.
9 SINGH A,VAJPEYI I N. Comparative study of lumboperitoneal shunt versus ventriculoperitoneal shunt in post meningitis communicating hydrocephalus in children[J]. Neurol India,2013,61(5):513-516.
10 ZHANG X H,WANG X G,PIAO Y Z,et al. Lumboperitoneal shunt for the treatment of leptomeningeal metastasis[J]. Med Hypotheses,2015,84(5):506-508.
11 HELBOK R,OLSON D M,LE ROUX P D,et al. Intracranial pressure and cerebral perfusion pressure monitoring in non-TBI patients:special considerations[J]. Neuro Critical Care,2014,21(Suppl 2):85-94.
12 张粉霞,刘荣,常袆,等.亚低温治疗新生儿缺氧缺血性脑病后S100-β蛋白、NSE的变化分析[J].中国妇幼保健,2017,32(3):517-519.
13 宋敏鹰.侧脑室-腹腔分流术治疗脑积水临床观察[J].中国实用神经疾病杂志,2015,18(10):17-19.
14 王珏.交通性脑积水采用抗磁多档可调压分流装置行腰大池腹腔分流术的体会[J].中外医学研究,2017,15(10):9-11.
15 王一芳,谭启富,许爱刚,等.应用可调压分流管行腰大池腹腔分流治疗创伤后脑积水的临床分析[J].东南国防医药,2015,17(5):464-466.
2 刘瑞,梁广榆,高亚飞.脑室腹腔分流术治疗外伤性脑积水中分流管的选择[J].临床医学研究与实践,2016,1(23):94-95.
3 ANDREASEN T H,HOIST A V,LILJA A,et al. Valved or valveless ventriculoperitoneal shunting in the treatment of post-haemorrhagic hydrocephalus:a population-based consecutive cohort study[J]. Acta Neurochirurgica(Wien),2016,158(2):261-270.
4 黄程.分期脑室-腹腔分流术及颅骨修补术治疗外伤性脑积水合并颅骨缺损患者的临床效果[J].实用临床医药杂志,2016,20(13):94-95.
5 鲁军体,王娜,刘炎伟,等.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患者的效果比较[J].检验医学与临床,2017,14(10):1429-1433.
6 ZHANG Y,ZHU X,ZHAO J,et al. Ventriculoperitoneal shunting surgery with open distal shunt catheter placement in the treatment of hydrocephalus[J]. Celt Biochem Biophys,2015,73(2):533-536.
7 ZHANG Y H,ZHANG C H,HU Z M,et al. Pancreatic cancer:open or minimally invasive surgery and the effects of minimally invasive removal of intracerebral hematoma on perihematomal matrix metalloproteinase[J]. World J Gastroenterol,2016,22(32):7301-7310.
8 李旭.不同分流方式在正常颅内压脑积水患者中的临床效果观察[J].国际医药卫生导报,2017,23(2):190-192.
9 SINGH A,VAJPEYI I N. Comparative study of lumboperitoneal shunt versus ventriculoperitoneal shunt in post meningitis communicating hydrocephalus in children[J]. Neurol India,2013,61(5):513-516.
10 ZHANG X H,WANG X G,PIAO Y Z,et al. Lumboperitoneal shunt for the treatment of leptomeningeal metastasis[J]. Med Hypotheses,2015,84(5):506-508.
11 HELBOK R,OLSON D M,LE ROUX P D,et al. Intracranial pressure and cerebral perfusion pressure monitoring in non-TBI patients:special considerations[J]. Neuro Critical Care,2014,21(Suppl 2):85-94.
12 张粉霞,刘荣,常袆,等.亚低温治疗新生儿缺氧缺血性脑病后S100-β蛋白、NSE的变化分析[J].中国妇幼保健,2017,32(3):517-519.
13 宋敏鹰.侧脑室-腹腔分流术治疗脑积水临床观察[J].中国实用神经疾病杂志,2015,18(10):17-19.
14 王珏.交通性脑积水采用抗磁多档可调压分流装置行腰大池腹腔分流术的体会[J].中外医学研究,2017,15(10):9-11.
15 王一芳,谭启富,许爱刚,等.应用可调压分流管行腰大池腹腔分流治疗创伤后脑积水的临床分析[J].东南国防医药,2015,17(5):464-466.