B超引导定位侧脑室-心房分流术治疗脑积水的疗效观察

Ultrasound-guided ventriculoatrial shunt in treatment of hydrocephalus:an observation of outcome

目的探讨B超引导定位侧脑室-心房分流术治疗脑积水的临床疗效。方法回顾分析13例脑积水患者临床资料,所有患者均行B超引导定位侧脑室-心房分流术,术后采用Salmon标准评定疗效,出院后通过门诊和电话定期对患者进行随访,记录并分析患者并发症诊治情况。结果 B超引导定位侧脑室-心房分流术一次穿刺成功率100%,手术平均时间(1.5±0.31)h。13例患者中12例脑室大小有不同程度缩小,症状明显改善。术后1个月根据Salmon分流术疗效评定标准,近期治疗有效12例,有效率为92.3%;随访半年内12例患者均无心内膜炎、心律失常、血栓形成等并发症发生。结论应用深静脉穿刺置管技术配合B超定位行脑室-心房分流术具有微创、操作时间短、定位准确等优点,值得临床推广。

Objective To investigate the clinical efficacy of ultrasound-guided ventriculoatrial shunt in the treatment of hydrocephalus.Methods The clinical data of 13 hydrocephalus patients were analyzed retrospectively;all of them underwent ultrasound-guided ventriculoatrial shunt.Salmon score was used to assess the clinical outcome after operation.The patients were followed up after operation by means of outpatient service and telephone.The diagnosis and treatment of complications of patients were recorded and the reasons were analyzed.Results The successful rate of first puncturing attempt was 100%,with the mean operative time being（1.5±0.31）h.The size of cerebral ventricles decreased to different degrees and the symptoms were greatly improved in 12 of the 13 patients.According to the efficacy standard of shunt therapy of Salmon,it was effective in12 cases one month after operation,with an effective rate of 92.3%.Six months follow-up found no complications such as endocarditis,arrhythmia or thrombosis in the patients.Conclusion Ultrasound-guided ventriculoatrial shunt combined with ultrasound-guided central venous catheter placement has the advantage of mini-invasion,shorter operating time,and accurate location,making it worth popularizing in clinic.