脑积水脑室－腹腔分流术失败后处理方式的探讨

Clinical study on treatments of failure ventriculo - peritoneal shunt for hydrocephalus

目的探讨脑积水脑室-腹腔（V—P）分流术失败后的处理方式。方法回顾性分析我院2005年7月至2010年7月收治的72例脑积水V—P分流术失败患者的临床资料。结果本组无死亡病例。行再次V—P分流术53例，脑室-心房（V—A）分流术14例，脑室镜下第三脑室底造瘘术3例，去除分流管2例。近期有效率为97％，2例1个月内又出现分流失败。结论脑积水V—P分流术失败后，针对不同的失败原因进行积极处理，可取得较好疗效。

Objective To explore treatments of patients after failure of ventriculo - peritoneal （ V - P） shunt for hydrocephalus. Method Clinical data of 72 patiens, treated for failure V - P shunt for hydrocephalus in our department from July 2005 to July 2010, were reviewed retrospectively. Results None died for hydrocephalus or related complications. After analysis for the reason of failure of V - P shunt, reoperation of V - P shunt was performed in 53 patients, ventriculo - atrial （ V - A） shunt was performed in 14 cases, shunt tube in the peritoneal was adjusted in 12 cases. Endoscopic third ventriculostomy was adopted in 3 cases. Shunt tubes in 2 patients were removed, and no deterioration was detected after periods of observation, either symptomatically or radiographically. The short term response rate was 97% , and 2 patients happended to be readjusted in one month after the treatment. Conclusion Active management based on analysis of different reasons for the failure of V - P shunt, could acquire satisfactory curative effects.