腰大池-腹腔分流术对交通性脑积水老年患者的疗效
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摘要
目的探讨腰大池-腹腔分流术治疗交通性脑积水老年患者的临床疗效。方法回顾性分析2014年1月—2017年1月,行腰大池-腹腔分流术治疗的16例交通性脑积水老年患者的临床资料。观察分析该术式的疗效及并发症。结果本组患者术后随访6～36个月,其中10例患者的手术效果为明显有效,4例患者为有效,2例患者无效,总有效率为87. 5%。所有患者均未出现手术相关并发症。结论腰大池-腹腔分流术治疗交通性脑积水老年患者的疗效显著,术后并发症少;值得临床推广应用。
Objective To investigate the clinical effect of lumboperitoneal shunt in the treatment of elderly patients with communicating hydrocephalus. Methods The clinical data of 16 elderly patients with communicating hydrocephalus treated by lumboperitoneal shunt from January 2014 to January 2017 were analyzed retrospectively. The effect and complication of this surgical approach were also analyzed. Results Of 16 patients,the follow up from 6 to 36 months showed 10 achieved obvious effect,2 achieved effective results and 2 achieved invalid results. The total effective rate was 87. 5%. There were no operative complications in all patients. Conclusions Lumboperitoneal shunt has a significant effect in the treatment of elderly patients with communicating hydrocephalus and less postoperative complications. It should be promoted for clinical use.
Objective To investigate the clinical effect of lumboperitoneal shunt in the treatment of elderly patients with communicating hydrocephalus. Methods The clinical data of 16 elderly patients with communicating hydrocephalus treated by lumboperitoneal shunt from January 2014 to January 2017 were analyzed retrospectively. The effect and complication of this surgical approach were also analyzed. Results Of 16 patients,the follow up from 6 to 36 months showed 10 achieved obvious effect,2 achieved effective results and 2 achieved invalid results. The total effective rate was 87. 5%. There were no operative complications in all patients. Conclusions Lumboperitoneal shunt has a significant effect in the treatment of elderly patients with communicating hydrocephalus and less postoperative complications. It should be promoted for clinical use.
引文
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[6]马驰原,王汉东.腰大池-腹腔分流术的技术要点[J].中华神经外科杂志,2013,29:65.
[7]王晓军,曹海波,卞杰勇,等.同期腰大池腹腔分流及颅骨修补术对交通性脑积水的临床疗效[J].临床神经外科杂志,2018;15:59.
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[12]中华神经外科分会神经创伤专业组.中华创伤学会分会神经创伤专业组.颅脑创伤后脑积水诊治中国专家共识[J].中华神经外科杂志,2014,30:840.
[13]龚江标,温良,杨小锋.不同分流方式治疗创伤后脑积水的疗效及并发症分析[J].中华创伤杂志,2016,32:105.
[14]Chiewvit S,Nuntaaree S,Kanchaanapiboon P,et al. Assessment lumboperitoneal or ventriculoperitoneal shunt patency by radionuclide technique:a review experience cases[J]. World J Nucl Med,2014,13:75.
[15]Yadav YR,Pande S,Raina VK,et al. Lumboperitoneal shunts:Review of 409 cases[J]. Neurol India,2004,52:188.
[16]Wang VY,Barbaro NM,Lawton MT,et al. Complications of lumboperitoneal shunts[J]. Neurosurgery,2007,60:1045.
[17]张赛.特发性正常压力脑积水诊疗思考[J].中华神经外科杂志,2011,27:642.
[18]Aoki T,Ayuzawa S,Matsuo R,et al. Laparoscopy-assisted ventriculoperitoneal and lumboperitoneal shunt surgery[J]. No Shinkei Geka,2012,40:511.
[19]Sosin M,Sofat S,Felbaum DR,et al. Laparoscopic-assisted peritoneal shunt insertion for ventriculoperitoneal and lumboperitoneal shunt placement:An institutional experience of 53 consecutive cases[J].Surg Laparosc Endosc Percutan Tech,2015,25:235.
[20]贺军华,金心,林亦海,等.气腹穿刺置管技术在腰大池-腹腔分流术中的应用[J].中华神经外科杂志,2016,32:1061.
[2]中国医师协会神经外科医师分会.中国脑积水规范化治疗专家共识[J].中华神经外科杂志,2013,29:634.
[3]谢英亮,王金鹏,常建永,等. V-P分流术治疗脑积水67例临床体会[J].中华神经外科杂志,2013,29:732.
[4]程钢戈,尹震,董连强,等.脑室-心房分流术治疗重型颅脑外伤合并脑积水[J].中华神经外科杂志,2001,17:60.
[5]何瞻,丁方,戎建东,等.腰大池腹腔分流术治疗重型颅脑外伤双侧去骨瓣减压术后交通性脑积水[J].浙江创伤外科,2016,21:970.
[6]马驰原,王汉东.腰大池-腹腔分流术的技术要点[J].中华神经外科杂志,2013,29:65.
[7]王晓军,曹海波,卞杰勇,等.同期腰大池腹腔分流及颅骨修补术对交通性脑积水的临床疗效[J].临床神经外科杂志,2018;15:59.
[8]Lu J,Zhao ZX,Chao Y,et al. Minimally-invasive treatment of communicating hydrocephalus using a percutaneous lumboperitoneal shunt[J]. J Zhejiang Univ-Sci B(Biomedicine&Biotechnology),2011,12:293.
[9]Bloch O,Mcdermott MW. Lumboperitoneal shunts for the treatment of normal pressure hydrocephalus[J]. J Clin Neurosci,2012,19:1107.
[10]Harold L,Donna W. Lumboperitoneal shunts in children[J].Pediatr Neurosurg,2003,38:41.
[11]VonDer Brelie C,Simon A,Gr9ner A,et al. Evaluation of an institutional guideline for the treatment of cerebrospinal fluid shuntassociated infections[J]. Acta Neurochir(Wien),2012,154:1691.
[12]中华神经外科分会神经创伤专业组.中华创伤学会分会神经创伤专业组.颅脑创伤后脑积水诊治中国专家共识[J].中华神经外科杂志,2014,30:840.
[13]龚江标,温良,杨小锋.不同分流方式治疗创伤后脑积水的疗效及并发症分析[J].中华创伤杂志,2016,32:105.
[14]Chiewvit S,Nuntaaree S,Kanchaanapiboon P,et al. Assessment lumboperitoneal or ventriculoperitoneal shunt patency by radionuclide technique:a review experience cases[J]. World J Nucl Med,2014,13:75.
[15]Yadav YR,Pande S,Raina VK,et al. Lumboperitoneal shunts:Review of 409 cases[J]. Neurol India,2004,52:188.
[16]Wang VY,Barbaro NM,Lawton MT,et al. Complications of lumboperitoneal shunts[J]. Neurosurgery,2007,60:1045.
[17]张赛.特发性正常压力脑积水诊疗思考[J].中华神经外科杂志,2011,27:642.
[18]Aoki T,Ayuzawa S,Matsuo R,et al. Laparoscopy-assisted ventriculoperitoneal and lumboperitoneal shunt surgery[J]. No Shinkei Geka,2012,40:511.
[19]Sosin M,Sofat S,Felbaum DR,et al. Laparoscopic-assisted peritoneal shunt insertion for ventriculoperitoneal and lumboperitoneal shunt placement:An institutional experience of 53 consecutive cases[J].Surg Laparosc Endosc Percutan Tech,2015,25:235.
[20]贺军华,金心,林亦海,等.气腹穿刺置管技术在腰大池-腹腔分流术中的应用[J].中华神经外科杂志,2016,32:1061.