脑室镜辅助与常规脑室腹腔分流术治疗脑积水术后并发症的比较研究

The comparative of the postoperative complications between the ventriculoscope auxiliary and conventional ventricu-loperitoneal shunt treatment for the hydrocephalus.

目的比较脑室镜辅助与常规脑室腹腔分流术治疗脑积水术后并发症的发生情况，为脑积水手术治疗方式的选择提供参考。方法选取我院收治的128例脑积水患者为研究对象，根据手术方式不同，分为常规脑室腹腔分流术组64例和脑室镜辅助脑室腹腔分流术组64例，比较两组患者术后并发症的发生率。结果脑室镜辅助手术组患者术后感染发生率为3．13％，引流管堵塞发生率为23．44％，腹部症状发生率为1．65％以及低颅压症状发生率为3．13％，均高于脑室镜辅助手术组（12．5％、53．13％、21．88％和18．75％），比较差异均有统计学意义（P〈0．05）。脑室镜辅助手术组患者术后脑实质内出血发生率为1．65％，与常规手术组（6．25％）比较无统计学意义（P〉0．05）。结论脑室镜辅助脑室腹腔分流术可有效避免术后感染、引流管堵塞、腹部症状、低颅压症状以及脑实质内出血等并发症的发生，值得临床推广。

Objective To compare the postoperative complications between the ventriculoscope auxiliary and conventional ventriculoperitoneal shunt treatment for the hydrocephalus, to provide the reference for the choice of the surgical treatment of hydrocephalus. Methods 128 cases of patient with hydrocephalus were selected as the research object and were divided into conventional ventriculoperitoneal shunt group （ n = 64 ） and ventriculoscope auxiliary ventriculoperitoneal shunt group （ n = 64 ） according to the different ways of operation. Then we compared the incidence of postoperative complications of the two groups. Results In the ventriculoscope auxiliary group, the incidence rate of postoperative infection was 3.13%, the incidence rate of drainage tube plugging was 23.44% , the incidence rate of abdominal symptoms was 1.65% and the incidence rate of low cranial pressure symptoms was 3.13%, which were higher than in the conventional ventriculoperitoneal shunt group （ 12.5% ,53.13% ,21.88% and 18.75% ） , the comparative differences were statistical significance （P 〈 0.05 ） ; the incidence rate of postoperative parenchymal hemorrhage was 1.65%, which was no statistical significance with that of the conventional ventriculoperitoneal shunt group （ P 〉 0.05 ）. Conclusion The ventriculoscope auxiliary ventriculoperitoneal shunt can effectively avoid postoperative infection, drainage tube plugging, abdominal symptoms, lower cranial pressure symptoms and parenchymal hemorrhage, which is worth of clinical promotion.