脐静脉-门静脉再通在治疗创伤性脑积水中的应用

Application of re-canalization between umbilical and portal veins for traumatic hydrocephalus

目的探讨脐静脉-门静脉再通在创伤性脑积水治疗中的手术技巧和应用。方法回顾性分析12例创伤性脑积水病人的临床资料,术中脐静脉-门静脉成功再通,经脐静脉行侧脑室-门静脉分流术,观察术后分流效果及临床症状改善情况,结合有关文献总结手术经验与技巧。结果术中12例病人脐静脉-门静脉成功再通,术后临床症状明显改善,未出现分流管堵塞、感染、血栓等并发症,随访10~18个月,复查头部CT脑积水均有不同程度改善11例,余1例无变化。结论脐静脉-门静脉再通成功率高,经脐静脉行侧脑室-门静脉分流术治疗脑积水可取得较好的疗效。

Objective To explore the surgical skill of re-canalization between the umbilical vein and portal vein and its clinical value in traumatic hydrocephalus. Methods Clinical data of 12 patients with traumatic hydrocephalus were analyzed retrospectively, who underwent ventricular-portal vein shunt via the umbilical vein by re-canalization between the umbilical vein and portal vein. The therapeutic efficacy and clinical improvement of symptoms were observed after surgery, and related literatures were reviewed to summarize the surgical experiences and skills. Results The umbilical and portal veins were successful re-canalized in 12 patients, the clinical symptoms significantly improved after surgery, and no significant complications such as tube blockage, infection, blood clots occurred. The patients were followed up for 10 to 18 months, the head CT showed that the hydrocephalus was improved to different degrees in 11 patients and remained stable in 1. Conclusions The success rate of re-canalization between umbilical and portal veins is high. The ventricular-portal shunt via the umbilical vein for traumatic hydrocephalus can obtain good outcome.