脊髓蛛网膜下腔-腹腔分流术治疗交通性脑积水临床分析

SPINAL SUBARACHNOID- PERITONEAL SHUNTING IN THE TREATMENT OF COMMUNICATING HYDROCEPHALUS

目的 探讨应用“腰-腹腔脑脊液分流系统”行脊髓蛛网膜下腔-腹腔分流术治疗颅内动脉瘤破裂后慢性脑积水的临床经验。方法 回顾分析36例应用脊髓蛛网膜下腔-腹腔分流术治疗颅内动脉瘤破裂后慢性脑积水患者的临床结果。总结“腰-腹腔脑脊液分流系统”在该类患者中应用的临床经验。结果 36例患者随访3～16个月,34例脑积水均得到控制,复查CT脑室系统都有不同程度缩小,临床症状不同程度好转,2例出现阻塞,需再次手术调整,1例出现低颅压反应;无1例出现感染,无1例出现腰痛不适。结论 此分流方法治疗颅内动脉瘤破裂后慢性性脑积水具有微创、并发症少、操作简便、效果良好的特点,值得临床推广。

Objective To introduce the clinical experience of lumboperitoneal shunting in the treatment of communicating hydrocephalus following aneurysmal subaraehnoid hemorrhage using Lumboperitoneal Catheter and Shunt Systems. Methods The clinical data of 36 patients with chronic hydrocephalus underwent lumboperitoneal shunting were retrospectively reviewed and analyzed to summarize the clinical experience of Lumboperitoneal Catheter and Shunt Systems used in lumboperitoneal shunting. Results All 36 cases were followed up for 3 to 16 months. 34 cases of hydrocephalus were under control, CT in the re - examination showing shrinkage of ventricles. Most symptoms disappeared, but 2 patients underwent re - shunting due to obstruction and 1 patient developed lower intracranial pressure. Neither shunt - related infections nor low back pains occurred. Conclusion Lumhoperitoneal shunting in the treatment of chronic hydrocephalus is minimally invasive with less complication, convenient and effective, and therefore is worthy of clinical promotion.