低颅压脑积水的手术治疗分析

Analysis of the Operation Treatment of Low Pressure Hydrocephalus

目的分析与探讨低颅压脑积水患者的临床特征,并总结患者采取手术治疗后的临床疗效。方法选取该院2009年6月—2012年6月期间收治的低颅压脑积水患者共30例,根据患者的临床情况分为A组(15例)与B组(15例),A组患者采用可调压式分流管进行分流术治疗,B组患者采用固定压式分流管进行分流术治疗。对比两组患者治疗后的临床疗效,并对患者进行随访,统计两组的并发症发生率。结果两组患者在随访期间均未发生死亡,A组患者术后显效共10例,有效共4例,无效共1例,总有效率为93.3%;B组患者术后显效共7例,有效共4例,无效共4例,总有效率为73.3%。两组患者总有效率差异有统计学意义(P<0.05)。A组患者术后发生感染1例,堵管1例,并发症发生率为13.3%;B组患者术后发生感染3例,分流过度共2例,分流不足共1例,并发症发生率为40.0%。两组患者并发症发生率差异有统计学意义(P<0.05)。结论对于低颅压脑积水患者,采取手术治疗时,选用可调压式分流管进行分流治疗的临床疗效更佳,安全性更高。

Objective To analyze and discuss the clinical features of patients with low pressure hydrocephalus, and summarize the clinical effect of the operation treatment for the patients, nethod A total of 30 cases of patients with low pressure hydrocephalus admitted in our hospital from June, 2009 to June, 2012 were selected and divided into A group （15 cases） and B group （15 cases） according to the clinical conditions of the patients. The patients of A group were treated with an adjustable shunt tube, and the patients of B group were treated with a fixed shunt tube. The clinical efficacy of two groups after treatment was compared. And the patients were followed up, the incidences of complications of the two groups were counted. Results No patients died during the follow-up. In A group, the treatment effect was excellent in 10 cases, effective in 4 cases, invalid in 1 case, the total effective rate was 93.3%; in B group, the treatment effect was excellent in 7 cases, effective in 4 cases, invalid in 4 cases, the total effective rate was 73.3%. The difference between the two groups in total effective rate was significant （P〈0.05）. In A group, postoperative infection occurred in 1 case, plugging in 1 case, the incidence of complications was 13.3%; in B group, postoperative infection occurred in 3 cases, split over in 2 cases, inadequate shunt in 1 case, the incidence of complications was 40.0%. The difference in the incidence of complications between the groups was significant（P〈0.05）. Conclusion Adjustable shunt tube treatment has better clinical curative effect and higher safety for low pressure hydrocephalus patients when they take operation therapy.