改良脑室腹腔分流术的临床应用

Clinical Application of Laparoscopy-guided Ventriculoperitoneal Shunt

【目的】比较腹腔镜辅助下脑室腹腔分流术（VPS）和常规剖腹VPS的临床疗效，探讨腹腔镜辅助下VPS的临床应用经验。【方法】回顾性总结分析20例腹腔镜辅助下VPS和20例常规剖腹VPS分流术的临床资料，分析比较两种手术方式的手术效果及并发症发生率。【结果】常规剖腹VPS组20例中1例出现分流管腹腔端梗阻、移位，1例出现术后感染。腹腔镜辅助下VPS组20例患者术后均恢复良好，症状均有不同程度的缓解，且无与腹腔镜手术相关的并发症发生。【结论】腹腔镜辅助下脑室腹腔分流术安全可靠，定位准、创伤小、术后并发症少等优点，有良好的临床应用前景。

[Objective] To compare the clinical effectiveness of ventriculoperitoneal shunt（VPS） assisted by laparoscope versus VPS via traditional laparotomy in treating hydrocephalus. [Methods] The clinical data of 20 cases of VPS by laparoscope assistance and 20 cases of VPS via traditional laparotomy were retrospectively analyzed. The operation efficacy and the incidence of complications were compared between the two groups. [Results] Among 20 patients in traditional laparotomy group after operation, there was one peritoneal catheter obstruction or displacement and one postoperative infection. All 20 patients in the laparoscope group after op- eration had good recovery and symptomatic relief, and had no complication related to laparoscopic surgery. [Conclusion]The technique of VPS assisted by laparoscope is safe and reliable, and has the advantages of accu- rate positioning,minimal injury and less postoperative complications. Therefore it is worthy of clinical application and popularization.