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1、·906·中国现代神经疾病杂志2014年10月第14卷第10期ChinJContempNeurolNeurosurg,October2014,Vol.14,No.10·临床研究·两种不同术式治疗交通性脑积水临床分析郑安锡黄晓明袁晓东唐文华陈世平程文张瑜【摘要】目的探讨两种手术方式治疗交通性脑积水之疗效和并发症。方法分别采用脑室⁃腹腔分流术或腰大池⁃腹腔分流术治疗43例交通性脑积水患者,比较其疗效和并发症发生率。结果两种术式疗效比较,差异无统计学意义(均P>0.05),但脑室⁃腹腔分流术组癫[36
2、.36%(8/22)对0,P=0.008]、感染[36.36%(8/22)对4.76%(1/21),P=0.030]、颅内出血[27.27%(6/22)对0,P=0.032]等并发症发生率高于腰大池⁃腹腔分流术组。结论腰大池⁃腹腔分流术治疗交通性脑积水之疗效优于脑室⁃腹腔分流术,大多数患者可以腰大池⁃腹腔分流术替代脑室⁃腹腔分流术。【关键词】脑积水;脑室腹膜分流术;手术后并发症Clinicalanalysisoftwokindsofsurgicalproceduresforthetreatmen
3、tofcommunicatinghydrocephalusZHENGAn⁃xi,HUANGXiao⁃ming,YUANXiao⁃dong,TANGWen⁃hua,CHENShi⁃ping,CHENGWen,ZHANGYuDepartmentofNeurosurgery,AffiliatedHospitalofChengduUniversity,Chengdu610081,Sichuan,ChinaCorrespondingauthor:ZHENGAn⁃xi(Email:zhenganxi@hot
4、mail.com)【Abstract】ObjectiveToexplorethetherapeuticeffectsandcomplicationsoftwokindsofsurgicalproceduresforthetreatmentofcommunicatinghydrocephalus.MethodsVentriculoperitonealshunt(VPS)andlumboperitonealshunt(LPS)wererespectivelyadoptedtotreat43cases
5、ofcommunicatinghydrocephalus.Thetherapeuticeffectsandcomplicationswereanalyzed,andrelatedliteratureswerereviewed.ResultsNosignificantdifferencewasfoundbetween2groupsintherapeuticeffects,suchasalleviatingheadache,improvingintelligenceandventricleshrin
6、king(P>0.05,forall).Theincidenceofcomplicationsofventriculoperitonealshunt,mainlyincludingepilepsy[36.36%(8/22)vs0,P=0.008],infection[36.36%(8/22)vs4.76%(1/21),P=0.030],intracranialhemorrhage[27.27%(6/22)vs0,P=0.032],andsoonwassignificantlyhigherthan
7、thatoflumboperitonealshunt.ConclusionsForcommunicatinghydrocephalus,theeffectoflumboperitonealshuntisbetterthanthatofventriculoperitonealshunt,sothelattercanbereplacedbytheformerinmostcases,exceptforinfectionorseriousabnormalityatoperativesite.【Keywo
8、rds】Hydrocephalus;Ventriculoperitonealshunt;Postoperativecomplications交通性脑积水的常用手术方式为脑室⁃腹腔分床提供一些参考。流术(VPS),但术后易发生穿刺部位血肿、颅内感[1]资料与方法染、过度分流、癫等并发症。因此,有学者采用[2]腰大池⁃腹腔分流术(LPS)治疗脑积水。笔者对成一、一般资料都大学附属医院神经外科2010年8月-2013年12月共43例患者,男性25例,女性18例;年龄18~施行脑室⁃腹腔分流术或腰大池⁃