脑室-腹腔分流术治疗非小细胞肺癌柔脑膜转移颅高压

Ventriculoperitoneal shunt for intracranial hypertension associated with leptomeningeal metastases from non-small cell lung cancer

目的探讨脑室-腹腔分流术治疗非小细胞肺癌柔脑膜转移颅高压的效果及特点。方法回顾性分析4例采用脑室-腹腔分流术治疗非小细胞肺癌柔脑膜转移颅高压的病例资料。术前腰椎穿刺压力均高于300 mmH_2O,CT及MRI检查未见脑积水表现。结果 4例病人术后颅高压症状明显改善,无手术相关并发症。随访2～14个月,死亡3例,1例存活,未见腹部转移征象。结论脑室-腹腔分流术能明显改善非小细胞肺癌柔脑膜转移病人的颅高压症状,改善生活质量,分流泵压力可设置为180～200 mmH_2O。

Objective To explore the effect and characteristics of ventriculoperitoneal shunt for intracranial hypertension caused by leptomeningeal metastases from non-small cell lung cancer.Methods The clinical data of 4patients with intracranial hypertension associated with leptomeningeal metastases from non-small cell lung cancer were analyzed retrospectively.The pressure of CSF via lumbar puncture was higher than 300mmH2O before operation.CT and MRI examinations showed no hydrocephalus.Results The symptoms of intracranial hypertension were obviously relieved in the 4patients after ventriculoperitoneal shunt.There were no postoperative complications.The follow-up ranged from 2 to 14 months.Death occurred in 3 cases,and survival without signs of abdominal metastasis in 1.Conclusions Ventriculoperitoneal shunt can relieve the symptoms of intracranial hypertension in the patients with leptomeningeal metastases from non-small cell lung cancer and improve the quality of life.The pressure of the shunt pump can be set at 180-200mmH2O.