切换至 "中华医学电子期刊资源库"

中华神经创伤外科电子杂志 ›› 2022, Vol. 08 ›› Issue (03) : 173 -177. doi: 10.3877/cma.j.issn.2095-9141.2022.03.008

短篇论著

腰大池-腹腔分流术治疗交通性脑积水的临床疗效分析
韦强1, 秦赢1, 王光明1, 周立祥1, 付双林1, 栾永昕1,()   
  1. 1. 130021 长春,吉林大学第一医院神经创伤外科
  • 收稿日期:2022-01-21 出版日期:2022-06-15
  • 通信作者: 栾永昕
  • 基金资助:
    吉林省医疗卫生人才专项(JLSCZD2019-067)

Clinical efficacy analysis of lumboperitoneal shunt in the treatment of communicating hydrocephalus

Qiang Wei1, Ying Qin1, Guangming Wang1, Lixiang Zhou1, Shuanglin Fu1, Yongxin Luan1,()   

  1. 1. Department of Neurotramasurgery, the First Hospital of Jilin University, Changchun 130021, China
  • Received:2022-01-21 Published:2022-06-15
  • Corresponding author: Yongxin Luan
引用本文:

韦强, 秦赢, 王光明, 周立祥, 付双林, 栾永昕. 腰大池-腹腔分流术治疗交通性脑积水的临床疗效分析[J]. 中华神经创伤外科电子杂志, 2022, 08(03): 173-177.

Qiang Wei, Ying Qin, Guangming Wang, Lixiang Zhou, Shuanglin Fu, Yongxin Luan. Clinical efficacy analysis of lumboperitoneal shunt in the treatment of communicating hydrocephalus[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2022, 08(03): 173-177.

目的

分析腰大池-腹腔分流术(LPS)治疗交通性脑积水的临床疗效。

方法

收集吉林大学第一医院神经创伤外科自2018年8月至2021年8月收治的32例行LPS治疗的交通性脑积水患者的临床资料,观察患者术前、术后一般情况及术后影像学检查、临床表现等,分析LPS治疗交通性脑积水的临床疗效。

结果

32例患者术后GCS评分、KPS评分均高于术前,Evan’s指数低于术前,差异均有统计学意义(P<0.05)。23例(71.88%)患者的Salmon预后有所改善,9例(28.12%)患者无变化或症状恶化。

结论

LPS治疗对于治疗椎管内无堵塞性疾病的交通性脑积水有良好治疗效果。

Objective

To analyze the clinical efficacy of lumboperitoneal shunt (LPS) in the treatment of communicating hydrocephalus.

Methods

The clinical data of 32 patients with communicating hydrocephalus who underwent LPS surgery in the Neurotramasurgery Department of the First Hospital of Jilin University from August 2018 to August 2021 were selected. The general conditions before and after operation, postoperative imaging examination and clinical manifestations were observed, and the clinical efficacy of LPS in the treatment of communicating hydrocephalus was analyzed.

Results

The postoperative GCS score and KPS score of 32 patients were higher than the preoperative scores, and Evan's index was lower than the preoperative scores, and the difference was statistically significant (P<0.05). The prognosis of Salmon was improved in 23 patients (71.88%), and there was no change or deterioration of symptoms in 9 patients (28.12%).

Conclusion

LPS is an effective surgery as a treatment of communicating hydrocephalus without occlusive diseases in the spinal canal.

图1 32例患者的Salmon预后分级结果
表1 32例患者术前及术后的预后指标对比
图2 典型病例术前、术后影像学资料A:病例1术前CT示脑室系统扩大;B:病例1术后CT示脑室系统明显较术前减小);C:病例2术前CT示脑室系统扩大;D:病例2术后CT示脑室系统较术前略有改善
[1]
Bondurant CP, Jimenez DF. Epidemiology of cerebrospinal fluid shunting[J]. Pediatr Neurosurg, 1995, 23(5): 254-258; discussion 259.
[2]
朱国刚,仇晨,张建辉,等. LP与VP治疗颅脑创伤后脑积水患者的临床疗效比较[J].医学临床研究, 2016, 33(8): 1622-1624.
[3]
陈登奎,庄进学,薛峰,等.脑积水脑室-腹腔分流术后并发症与处理[J].中国微侵袭神经外科杂志, 2013, 18(12): 558-559.
[4]
冉德森,冉旸.脑室-腹腔分流术并发症及其防治[J].中国医药科学, 2017, 7(6): 148-150.
[5]
Bayar MA, Tekiner A, Celik H, et al. Efficacy of lumboperitoneal shunting in patients with normal pressure hydrocephalus[J]. Turk Neurosurg, 2018, 28(1): 62-66.
[6]
Sun T, Yuan Y, Zhang Q, et al. Establishing a preoperative evaluation system for lumboperitoneal shunt: approach to attenuate the risk of shunt failure[J]. World Neurosurg, 2018, 117: e308-e315.
[7]
Bret P, Hor F, Huppert J, et al. Treatment of cerebrospinal fluid rhinorrhea by percutaneous lumboperitoneal shunting: review of 15 cases[J]. Neurosurgery, 1985, 16(1): 44-47.
[8]
Zhang XH, Wang XG, Piao YZ, et al. Lumboperitoneal shunt for the treatment of leptomeningeal metastasis[J]. Med Hypotheses, 2015, 84(5): 506-508.
[9]
毛元潮,周冀英.脑脊液循环动力学原理及临床表现[J].重庆医学, 2009, 38(7): 859-861.
[10]
刘佰运,郭尔安.脑室-腹腔分流术的"三步消毒法"介绍[J].中华神经创伤外科电子杂志, 2021, 7(2): 65-67.
[11]
Kumar R, Younus SM, Haseeb A, et al. Frequency of infection associated with ventriculo-peritoneal shunt placement[J]. J Pak Med Assoc, 2016, 66(7): 815-818.
[12]
Woo PY, Wong HT, Pu JK, et al. Primary ventriculoperitoneal shunting outcomes: a multicentre clinical audit for shunt infection and its risk factors[J]. Hong Kong Med J, 2016, 22(5): 410-419.
[13]
Reddy GK, Bollam P, Caldito G. Ventriculoperitoneal shunt surgery and the risk of shunt infection in patients with hydrocephalus: long-term single institution experience[J]. World Neurosurg, 2012, 78(1-2): 155-163.
[14]
卢盛华,赵志刚,王学蛟,等. "三步消毒法"降低脑室-腹腔分流术后颅内感染率初步效果观察[J].中华神经创伤外科电子杂志, 2021, 7(2): 107-111.
[15]
刘磊,马陈建,高雪,等.反麦氏点入路对脑室-腹腔分流术后腹腔端堵管调管术疗效观察[J].中华神经创伤外科电子杂志, 2019, 5(5): 304-306.
[16]
孙书光. V-P分流术和L-P分流术在正常颅内压脑积水患者中的临床效果差异[J].中国实用医药, 2016, 11(30): 98-99.
[17]
郑安锡,黄晓明,袁晓东,等.两种不同术式治疗交通性脑积水临床分析[J].中国现代神经疾病杂志, 2014, 14(10): 906-909.
[18]
饶文旭.脑室腹腔分流术和腰大池腹腔分流术治疗正常颅内压脑积水患者的效果比较[J].中国民康医学, 2018, 30(7): 38-39.
[19]
赵永田.腰大池腹腔分流与脑室-腹腔分流术治疗正压性脑积水比较[J].中国卫生标准管理, 2019, 10(9): 73-75.
[20]
Eymann R, Chehab S, Strowitzki M, et al. Clinical and economic consequences of antibiotic-impregnated cerebrospinal fluid shunt catheters[J]. J Neurosurg Pediatr, 2008, 1(6): 444-450.
[21]
宋志军,陈晓雷,唐运林,等.脑室镜与腹腔镜在交通性脑积水脑室-腹腔分流中的联合应用[J].中华外科杂志, 2015, 53(10): 772-775.
[1] 袁涛, 钱洪, 杨少强, 赖圳登, 孟嘉, 江辉, 赵建宁, 包倪荣. 关节镜下全内缝合技术治疗冈上肌肌腱关节面撕裂[J]. 中华关节外科杂志(电子版), 2022, 16(05): 611-615.
[2] 张海东, 滕涛, 刘俊英, 郭艾, 张洪瑞, 陈阳, 肖斌, 王凯伦. 基于磁共振软骨影像的膝骨关节炎关节镜疗效评估[J]. 中华关节外科杂志(电子版), 2021, 15(06): 666-672.
[3] 黄廷杰, 贺毅, 黄建荣. 胫骨平台后外侧髁骨折的治疗及评价进展[J]. 中华关节外科杂志(电子版), 2021, 15(04): 476-481.
[4] 刘思杰, 刘哲华, 李海亚, 张宏伟, 范晓东, 张敬堂. 比较两种手术方法治疗高龄股骨转子间不稳定骨折[J]. 中华关节外科杂志(电子版), 2021, 15(04): 397-403.
[5] 柳宁强, 梁钰琪, 王聪, 穆生瑞, 解桐, 郭崇军, 牛东生. 不同间隔时间对分期双侧全膝关节置换术的影响[J]. 中华关节外科杂志(电子版), 2021, 15(03): 345-349.
[6] 李涛, 杨义, 冯光, 郝岱峰. 北京市某三甲医院创面修复专科病区5年间糖尿病足住院病例回顾性分析[J]. 中华损伤与修复杂志(电子版), 2022, 17(05): 405-410.
[7] 郭志文, 蒋方. 双极电切术治疗前列腺增生合并腹股沟疝的研究[J]. 中华疝和腹壁外科杂志(电子版), 2021, 15(04): 386-389.
[8] 王刚, 单伟根, 刘娟, 李长庆, 王新民. 常规治疗联合阿托伐他丁钙片对支气管扩张症临床分析[J]. 中华肺部疾病杂志(电子版), 2023, 16(04): 538-540.
[9] 杨慧, 杨亮, 郭建英. PDCA循环管理对哮喘用药依从性疗效分析[J]. 中华肺部疾病杂志(电子版), 2021, 14(04): 525-527.
[10] 赵海林, 王璐璐, 罗冬冬, 胡骕, 李丹, 彭彪. 脑室-腹腔分流术对脑膜转移癌的治疗效果分析[J]. 中华神经创伤外科电子杂志, 2022, 08(06): 335-340.
[11] 吴晓凡, 罗书引, 冯二艳. 交通性脑积水脑室-腹腔分流术后迟发性颅内出血发生风险的列线图预测模型构建与评估[J]. 中华神经创伤外科电子杂志, 2022, 08(05): 276-281.
[12] 贾春娟, 房贤村, 刘云霞, 吴华清. 自拟中药方剂(血安胃康)联合西药治疗上消化道出血的临床研究[J]. 中华消化病与影像杂志(电子版), 2022, 12(01): 26-29.
[13] 彭如辉, 周德春, 吴庆鸣, 杨忠. 经皮经椎间孔脊柱内镜技术治疗老年退变性腰椎管狭窄症疗效分析[J]. 中华老年病研究电子杂志, 2021, 08(04): 14-17.
[14] 高猛, 郭军, 董松格. 老年股骨颈骨折患者行髋关节置换术后髋关节功能恢复的相关影响因素分析[J]. 中华老年病研究电子杂志, 2021, 08(04): 10-13.
[15] 汪赓, 夏泽锋, 陶凯雄. 代谢手术在非肥胖型2型糖尿病中的治疗效果及研究进展[J]. 中华肥胖与代谢病电子杂志, 2023, 09(03): 155-160.
阅读次数
全文


摘要