分流管调整术在急性进展的正常颅压脑积水患者中的应用及预后评价

Application Effect Observation and Prognosis Evaluation of Diversion Canal Adjustment in Patients with Acute Progress of Normal Pressure Cranial Hydrocephalus

目的:对急性进展的正常颅压脑积水患者行分流管调整术,分析其应用效果及预后。方法:回顾性分析我院2013年10月~2015年10月收治的19例急性进展的正常颅压脑积水患者,所有患者于术前均被确诊为正常颅压脑积水,12例患者放置可调压抗虹吸分流管,7例放置可调压分流管,对患者实施分流管调整术,分析其对患者的临床改善情况,并随访4个月~1年后观察其预后情况。结果:所有患者经全麻下分流管调整术,并调整脑脊液水平达到合适压力,手术均获得成功并出院。经4个月~1年的随访,15例步态不稳改善,9例痴呆改善,4例尿失禁改善,其中步态不稳情况改善最为显著;19例患者中,1例分流管堵塞,1例感染,并发症发生率为10.5%。结论:对急性进展的正常颅压脑积水患者行分流管调整术具有较好的临床改善情况,且并发症相对较少,是一种安全有效的治疗方法。

Objective： In patients with acute progress of normal pressure cranial hydrocephalus shunt line adjustment, analyzes its application effect and prognosis. Method： Retro- spective analysis in October 2013 to October 2015 were 19 cases of acute progress of normal pressure cranial hydrocephalus patients, all patients were diagnosed with normal pressure crani- al hydrocephalus before operation, 12 patients were placed adjustable voltage shunt resistance to siphon, 7 cases of adjustable voltage shunt placement, for patients with ventricle peritoneal shunt, analysis of shunt tube to adjust the clinical improvement of patients during operation, and follow-up of 4 months ~ 1 year after the prognosis was observed. Result： All patients under general anesthesia diversion canal to adjust, and adjust the level of cerebrospinal fluid to the appropriate pressure, operation suc- cess and discharged from hospital. During the follow-up period of 4 months ~ 1 year, 15 cases of unstable gait improvement, 9 cases of dementia improved, 4 cases of urinary incontinence im- provement, including gait instability situation to improve the most significant; In 19 patients, 1 case of diversion pipe block- age, 1 ease of infection, the incidence of complications was 10.5%. Conclusions： In patients with acute progress of normal pressure cranial hydrocephalus shunt line adjustment technique has better clinical improvement, and relatively few complications, and is a safe and effective treatment.