影响正常压力脑积水手术效果因素的探讨

FACTORS INFLUENCING THE SHUNT OF 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29例正常压力脑积水(NPH)病人临床症状、病程、年龄、影像学检查、腰椎穿刺释放试验等因素对脑室-腹腔分流术(V-PS)的影响及预后效果。结果:本组在术前腰穿实验1wk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72.4%,步态不稳术后有效率72.7%,智力障碍术后有效率55.6%,尿失禁术后有效率60%。结论:以步态不稳为主要症状,病程短、年轻、腰穿试验阳性者手术分流效果明显,以痴呆、尿失禁为主要症状者手术分流效果差。

Objective：To evaluate the factors influencing the shunt of normal pressure hydrocephalus（NPH）.Methods：The efficency of shunt was retrospectively analysed according to 29 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 effective rate was 72.4%,and the effective rate of patients with gait disturbance was 72.7%,patients with dysnoesia was 55.6%,patients with urinary incontinence was 60%.Conclusion：Young patients with gait disturbance and short course of disease have good or excellent response to surgery,whereas patients with dementia or urinary incontinence have poor response to surgery.