侧脑室-腹腔分流术治疗正常压力脑积水

Ventricular-peritoneal shunt in treatment of Normal pressure hydrocephalus

目的探讨正常压力脑积水(NPH)诊断和手术病例的选择方法,分析侧脑室-腹腔分流术治疗正常压力脑积水的效果。方法回顾性分析16例正常压力脑积水病人TAP试验前后步距、步速、转身步数,手术前后临床症状、KPS评分,腰穿测压和术中测压的结果。结果本组16例病人无手术死亡,无感染、脑内血肿,硬膜下积液1例。随访12个月,有效16例(100%),显效7例(43.75%)。结论正常压力脑积水的诊断和手术病例的选择需要综合分析临床资料;侧脑室-腹腔分流术能够改善病人临床症状,提高其生活质量。

Objective To evaluate the diagnostic strategy of normal pressure hydrocephalus （NPH）, the selection of surgical cases and the therapeutic effect of ventricular-peritoneal shunt for NPH. Method The clinical data of 16 patients with NPH, including the step length, speed of walking and turning requiring steps before and after the TAP test were reviewed. The clinical symptoms, KPS score before and postoperative, CSF pressure at lumbar puncture and the operation were analyzed retrospectively. Results All patients had no death, no infection and intracerebral hematoma, except 1 patient with subdural effusion. There were 7 cases （43.75%） with significant curative effect and 16 （ 100% ） with improvement during the following up of 12 months. Conclusion It needs analysis by synthesis for the diagnosis of NPH and the selection of surgical cases. Ventricular-peritoneal shunt can improve the clinical symptom and the living quality.