影响正常压力脑积水分流术疗效因素的探讨

Factors influence the shunting normal pressure hydrocephalus

目的:探讨影响正常压力脑积水分流手术效果的因素。方法:回顾性分析31例正常压力脑积水(NPH)患者临床症状、病程、年龄、腰椎穿刺放液试验等因素对脑室-腹腔分流术的影响及预后效果。结果:本组在术前腰穿实验后1周内症状有所改善17例,无手术死亡病例。依照疗效判定标准,本组总有效率70.9%。步态不稳术后有效率72.7%,智力障碍术后有效率44.4%,尿失禁术后有效率40%。结论:以步态不稳为主要症状,病程短、年轻,腰穿试验阳性者分流手术效果好,以痴呆和尿失禁为主要症状者分流效果差。

Objective： To evaluate the factors acted on the shunting normal pressure hydrocephalus （NPH）. Methods： The efficacy of shunting was retrospectively analyzed according to 31 NPH patients＇ symptoms, medical history, age and test of draining cerebrospinal fluid（CSF） with lumbar puncture. Results： Seventeen patients got better after test of draining CSF with lumbar puncture, no one died. The total response rate was 70.9%, and the response rate of patients with gait disturbance was 72.7 %, of patients with amentia was 44.4 %, of patients with urine incontinence was 40%. Conclusion： Young patients with gait disturbance and short course of disease have good or excellent response to surgery, whereas patients with amentia or urine incontinence have poor response to surgery.