Codman-Hakim可调压式分流管在脑积水治疗中的应用

Clinical application of Codman-Hakim programmable valve in treatment of hydrocephalus

目的探讨Codman-Hakim可调压式分流管(CHPV)在脑积水治疗中的特点和优势。方法采用CHPV植入治疗不同类型脑积水病例53例。依据患者脑积水病因、病程、年龄、影像学特点、术中测压结果等做为调压阀开放压力(OP)初始值的设定依据,术后根据CT复查结果和患者症状进行调整。结果术后调压0～6次,平均1.8次。脑积水症状改善48例(90.5%),无显著变化5例(9.5%)。术后硬膜下血肿1例,硬膜外血肿1例,分流管腹腔端梗阻1例,双侧顽固性耳鸣1例。无其他并发症发生。结论CHPV在脑积水个体化压力设定分流治疗中优于固定压力分流管,临床应用中应重视其特殊性。

Objective To assess the value of Codman-Hakim programmable valve （CHPV） in treatment of hydrocephalus. Methods 53 sets of CHPV were implanted in patients with hydrocephalus underwent ventriculoperitoneal （V-P） shunt surgery from 2002 to 2008. The opening pressure （OP） were settled based on aspects such as intraoperative intraventricular pressure measurement, clinical manifestation, etiology and ventricular enlargement. Results In 38% of the cases valve pressure adjustment was required at least once （mean number of adjustments 1.8, maximum 6）. The patient＇s clinical status improved in 90. 5% after pressure adjustments. Conclusions The CHPV has better shunt performance than standard shunt valve in the treatment. It can be used in all conditions in which CSF should be drained.