脑室-腹腔分流术治疗正常压力脑积水的临床预后因素分析

An analysis of prognostic factors for ventriculo-peritoneal shunt in patients with NPH

目的研究影响正常压力脑积水(NPH)行脑室-腹腔分流手术预后的因素。方法从NPH患者的症状、病因、分流管的选择及腰穿放液试验、影像学表现、病程、年龄等因素分析手术效果。结果蛛网膜下腔出血、颅脑外伤、脑瘤术后引起的NPH手术效果好;临床以步态不稳为主要症状的手术效果好;选用低压分流管、腰穿放液试验症状改善的手术效果好;CT平扫脑室旁低密度区(PVL)和MRI检查室周、皮质下高信号的手术效果好;病程<6个月、年龄<60岁的手术效果好。结论影响NPH行脑室-腹腔分流手术预后的因素复杂,综合分析各因素对判断手术预后非常有益。

Objective To study prognostic factors for ventriculo - peritoneal shunting with normal pressure hydrocephalus （NPH）. Methods To efficacy of shunt was analysed according to the symptoms, causes of disease oselecting shunt and test of draining CSF with lumbar puncture, imageology, age and medical history. Results Patiens with gait disturbance, below 60 years of age and with in 6 months of illness after head injury, subarachnoid heamorrhage of cranial surgery all had good or excellent response to surgery. Good or excellent response to surgery, with low pressure shunt and could be gained if there was improvement of syndrome after CSF draining, CT finding low intensity areas at periventricular, MRI finding high signal in snbcortieal and periventrieular areas. Conclusion The prognostic factors for ventriculo - peritoneal shunt in patiens with NPH were complex, which should be analysed throughly before shunting was very beneficial.