可调压式脑室-腹腔分流阀治疗脑积水
Management of hydrocephalus with programmable valves
盛汉松 1刘伟国 1杨小锋 2温良 2马力 1范菁1
作者信息
- 1. 浙江大学医学院附属第二医院神经外科,浙江杭州,310009
- 2. 浙江大学医学院附属第一医院神经外科,浙江杭州,310003
- 折叠
摘要
目的:讨论可调压分流阀治疗脑积水的有效性和安全性并分析分流术后并发症.方法:通过自2004～2007住院36例脑积水患者使用可调压分流阀治疗,分析调节次数和分流术后的各种并发症和治疗效果,并与同时期使用固定压力阀门的患者进行比较.结果:治疗组未发生硬膜下积液或硬膜下血肿,无因为脑脊液分流过度或不足而需再次手术治疗者.分别有2例和4例患者由于出现堵管和感染现象,导致分流失败.疗效优秀率(89%),调节次数共46次;而对照组发生颅内血肿或积液6例,堵管和感染发生率与治疗组无统计学差异.结论:可调压分流阀对脑积水的治疗具有安全性,更符合脑脊液的循环,并能减少分流过度和不足的并发症,而分流术后的感染和堵管仍是脑室-腹腔分流分流失败的主要原因.
Abstract
AIM: To evaluate the effectiveness of programmable valves with hydrocephalus patients and to ascertain complications and safety issues arising from their use. METHODS: Programmable valves were used in 36 patients with hydrocephalus from 2004 to 2007. The frequency readjustments and complications of post-operation were analyzed. Outcomes of patients were collceted by follew up, and the results were compared in patients with hydrocephalus using standard valves. RESULTS: Significant sustained clinical improvement was achieved in 32/36 ( 89% ) of patients with programmable valves. The overall infection rate was 4/36 (11%) , valve blockage occurred in 2 cases and no subdural effusion or subdural hematoma demonstrated and no patient was reoperate owning to CSF overshunting or undershunting. The total readjustments were 46. In contrast, 6 paitents with standard valves developed intracranial hemorrage or subdural effusion. There was no difference in infection and valve obstruction between programmable and standard valves. CONCLUSION: Programmable valves can be safely used for treatment of hydrocephalus, and consistent with the cerebrospinal fluid circulation, reduce the either over-or under-drainage of the complications. The possibility of modifying their working pressure seems to constitute their main advantage. Catheter-related complications and shunt-related infections were the main reasons for revision and the major cause of shunt failure.
关键词
可调压式/脑室/腹腔/脑积水Key words
programmable/ventricle/peritoneal/hydrocephalus引用本文复制引用
出版年
2009
NETL
NSTL
万方数据