腰大池-腹腔分流术治疗创伤后脑积水的研究进展

Research progress in lumboperitoneal shunt for post-traumatic hydrocephalus

创伤后脑积水(PTH)是重型颅脑损伤后常见的继发性病变之一,分流手术是临床上最主要的外科治疗方式.分流术式有多种,采用何种术式目前尚无统一标准.腰大池-腹腔分流术(LP)作为可选择的一种重要术式,正逐步成为分流手术的主流方式之一.笔者从LP新的手术适应证、LP较传统脑室腹腔分流术(VP)的巨大优势、最新的术前评估手术系统及华西LP术前评估积分、LP手术的技术要点、随访要点和常见术后并发症及其处理等方面进行综述,为了解LP的技术路线及手术理念提高参考.

Post-traumatic hydrocephalus (PTH) is one of the common secondary lesions after severe craniocerebral injury. Shunt surgery is the most important surgical treatment in clinic. There are many kinds of shunt methods, but there is no uniform standard for method selection. Lumboperitoneal shunt (LP), as an important alternative operation, has gradually become one of the mainstream shunt operations. This article reviews the new operative indications of LP, the advantages of LP over traditional ventriculoperitoneal shunt (VP), the latest preoperative evaluation system and preoperative evaluation score of Huaxi LP, the technical points of LP operation, follow-up key points, common postoperative complications and management, so as to provide reference for exploring better technical routes and operative concepts of LP.