采用分流管调整术治疗急性进展的正常颅压脑积水的初步研究

A Preliminary Study for the Treatment of Acute Normal Pressure Hydrocephalus by Shunting Adjustment

目的：对急性进展的正常颅压脑积水（NPH）患者的诊断及治疗进行初步研究。方法：回顾性分析2010年9月至2013年6月间北京朝阳医院神经外科收治的8例表现为急性进展NPH患者资料。其中男5例,女3例,年龄57-74岁,平均65.3岁。所有患者术前均诊断为脑积水,6例被诊断为NPH,2例治疗过程中诊断为NPH。患者入院前均行脑室腹腔分流术,其中6例放置可调压抗虹吸分流管,2例放置可调压分流管。分析诊断其要点及治疗经过。结果：8例急性进展NPH患者,行全麻下分流管调整术治疗,均成功救治,术后随访3-30月,患者症状均获得改善,7例患者恢复正常,1例患者出院时候偶有尿失禁,随访3月后恢复正常。结论：急性进展的NPH患者,分流管调整到最低压力症状缓解不理想,行脑脊液分流装置调整术安全有效,并发症少。

Objective： Preliminary studies on acute normal pressure hydrocephalus （NPH） in the diagnosis and treatment of patients. Methods：Retrospectively analysis patients data Beijing Chaoyang Hospital between September 2010 to June 2013. eight cases were treated as acute progress NPH , Including 5 males and 3 females, aged 57 to 74 years, mean 65.3 years. All patients were diagnosed with hydrocephalus, six cases were diagnosed with NPH pre-admission, 2 Cases were diagnosed during admission. Patients before admission were undergone ventriculo-peritoneal shunt, of whom six were placed anti-siphon shunt systems regulatorly, two cases were placed normal adjustable shunt systems. Analysis of diagnosis and treatment were performed Results：8 cases of acute progressive NPH patients were performed shunt adjustment. patients were followed up from 3 to 30 months, symptoms were all improved, seven patients returned to normal, one patient was discharged with occasional incontinence and return to normal after follow-up 3 months. Conclusions：acute NPH progression patients who were poor response to pressure revision even to the lowest level , cerebrospinal fluid shunt adjustment surgery means safe and effective .