微创脑室-腹腔分流术治疗脑积水346例临床分析

Clinical analysis of ventriculoperitonea shunt for hydrocephalus: 346 cases report

目的总结微创脑室-腹腔分流术治疗脑积水的临床经验及治疗效果。方法自1996-01~2010-01对收治的346例脑积水患者行微创脑室—腹腔分流术,并对其临床资料及随访结果进行回顾性分析。结果术后随访0.5~14 a,有5例（1.4%）术后1~3周出现颅内感染,均为开颅术后脑积水患者,其中2例（0.6%）感染难以控制,予以终止分流。有2例（0.6%）出现慢性硬膜下血肿,均为本组早期患者。2例（0.6%）术后1~3个月出现脑室端引流管阻塞,均为开颅术后脑脊液混浊患者。结论开颅术后脑积水患者,分流术后感染几率、分流管阻塞几率相对较高。微创脑室-腹腔分流术简单易行,创伤小,并发症明显减少,效果良好,值得推广。

Objective To explore the surgical experience and adult of ventriculoperitoneal shunt for hydrocephalus.Methods The clinical data of 346 hydrocephalus patients performed ventriculoperitoneal shunt were analyzed retrospectively.Results Postoperative complications were found in 9 cases（average follow-up time was from 6 months to 14 years）,including 2 cases of shunt apparatus blockage,5 cases of postoperative shunt infection,2 cases of subdural hematoma.Conclusion The infection and shunt apparatus blockage is easy to appear in these patients which receive the craniotomy operation.Ventriculoperitoneal shunt with minimally invasion is simple to popularize which can reduce the occurrence of complication.