简易无框架立体定向脑室腹腔分流术疗效分析

Frameless stereotactic ventriculoperitoneal shunt

目的探讨简易无框架立体定向脑室腹腔分流术的临床效果。方法河南省人民医院神经外科自2012年3月至2016年3月行侧脑室穿刺腹腔分流术治疗脑积水患者128例，其中行简易无框架立体定向穿刺47例，传统枕角穿刺23例，传统三角区穿刺58例。回顾性分析患者的临床资料，比较不同穿刺方式下头端管放置位置及近期头端管调整情况。结果简易无框架立体定向侧脑室穿刺的患者中，头端管误入对侧脑室1例，无近期调整头端分流管病例；传统枕角穿刺的患者中，误人对侧脑室0例，误入脑质内5例，近期头端分流管调整3例；传统三角区穿刺的患者中，误人对侧脑室11例，误人纵裂池1例，放置到室间孔6例，误人脑质内2例，近期头端分流管调整及重置7例。结论简易无框架立体定向侧脑室穿刺可有效成功放置头端分流管，降低头端分流管近期调整或重置风险。

Objective To explore the clinical efficacy of simple fi＇ameless stereotactic ventricle peritoneal shunt. Methods Retrospective analysis was performed in 128 patients with hydrocephalus, admitted to and performed ventriculoperitoneal shunt in our hospital fi＇om March 2012 to March 2016： simple frameless stereotactic ventricle peritoneal shunt was performed in 47, traditional occipital horn puncture in 23, and traditional triangle puncture in 58. The respective end of shunt tube placement position and recent end shunt tube adjustment were analyzed retrospectively. Results Inappropriate position was achieved in one patient performed simple frameless stereotactic biopsy, and no recent change or reset the shunt pipe was performed. In patients accepted traditional pillow angle puncture, head end improper placement happened in 5 patients, adjustment of recent tip was performed in 3. In patients accepted traditional triangle puncture, incorrect triangle needle tip was placed in 20 patients, and recent change or reset the head end shunt was performed in 7. Conclusion Simple fi＇ameless stereotactic puncture is effective in shunt placement of head end, which can lower the head end shunt recent change or reset the risk.