外伤性脑积水侧脑室-腹腔分流术并发症的防治

Prevention and treatment of postoperative complications after lateral cerebral ventricle-peritoneal cavity(V-P) shunt for the treatment of traumatic hydrocephalus

目的探讨外伤性脑积水行脑室-腹腔分流术后的并发症及其原因与预防方法。方法对69例确诊外伤性脑积水患者,根据腰穿测压选择合适的分流管行脑室腹腔分流术。结果 术后20例患者出现并发症,其中11例并发分流管梗阻,1例急性硬膜外血肿,腹痛19例,均治愈。无直接手术死亡者。结论分流装置的阻塞及术后腹痛是最常见的并发症。前者主要与分流管泵阀压力选择不当有关,后者与分流管和脑脊液对腹膜的刺激有关。分流管阻塞者经及时调整可治愈。

Objective To analysis the complications after operative procedure of lateral cerebral ventricle-peritoneal cavity(V-P) shunt for the treatment of traumatic hydrocephalus,and to analysis the causes of the complications and their prevention through reviewing literature.Methods Sixty-nine patients diagnosed as traumatic hydrocephalus received V-P shunts according to the pressure of cerebrospinal fluid through lumbar puncture.Results Complications of operative procedure occurred in 20 patients,of whom 11 suffered from shunt catheter obstruction,one suffered from acute extradural hematoma,and 19 suffered from abdominal pain.They were all cured,and no one died directly due to the operation.Conclusion The obstruction of shunt devices and abdominal pain are the most common complications.The former is related to the inappropriate selection of shunt pump valve,and the latter is relevant to the stimulation of shunt catheter and cerebrospinal fluid.