微创技术方案下脑室腹腔分流术效果分析

Clinical effects of minimally invasive ventriculoperitoneal shunting

目的探讨采用微创手术操作技术实施脑室腹腔分流手术的效果。方法回顾性分析2017年2月至2021年2月北京博爱医院神经外科实施脑室腹腔分流手术的患者92例,术中采用减菌无沾染操作流程、最小化手术腔隙及简易徒手直视下定向穿刺技术。结果术后脑室端导管位置均达到理想位置,其中分流管相关感染1例,占1.1%;穿刺道迟发血肿2例,占2.2%;总体并发症仅3例,占3.3%,其余病例随访期间神经功能均有不同程度恢复,脑室系统Evan's指数减小、认知功能(MMSE)评分升高及肢体肌张力(MAS)评分下降,差异均有统计学意义(P均<0.05)。结论在实施脑室腹腔分流术过程中,采用微创操作技术可以降低围手术期并发症。

ObjectiveTo assess the clinical effects of minimally invasive ventriculoperitoneal shunting.MethodsNinety-two patients who underwent ventriculoperitoneal shunting at the Neurosurgery Department of Beijing Bo'ai Hospital from February 2017 to February 2021 were retrospectively analyzed.Aseptic operation steps,minimizing surgical cavity,and puncturing assisted with simple guide tools were adopted during surgery.ResultsAll the ventricular catheters were placed in the ideal position.There was one(1.1%)case of shunt related infection and two(2.2%)cases of delayed hematoma,and the overall rate of complications was 3.3%.The neurological function of the rest cases was improved.The Evan's index decreased,the Mini-Mental State Examination score increased,and the modified Ashworth scale score of extremity muscle tension were all improved significantly(P<0.05 each).ConclusionIn the process of ventriculoperitoneal shunting,the perioperative complications can be reduced by minimally invasive techniques.