脑室腹腔分流术中腹腔气腹穿刺术的应用研究

Application study of abdominal cavity pneumoperitoneum puncture in ventriculo-peritoneal shunt

目的探讨脑室腹腔分流术中腹腔气腹穿刺术的运用价值。方法选取本院2016年5月～2017年5月间收治的进行脑室腹腔分流术的患者60例临床资料作为本次研究对象,依据随机分配法将患者分为对照组与研究组,每组各30例;其中对照组患者术中采用传统手术方法,研究组患者术中采取腹腔气腹穿刺术。分析对比两组患者术后的影像检查结果、并发症发生情况以及生活质量等指标。结果两组患者术后4周影像检查中症状缓解情况对比差异有统计学意义(P<0.05);在半年内,研究组患者的并发症发生率显著低于对照组,差异有统计学意义(P<0.05);术前两组患者生活质量评价未存在显著性差异,术后1周、术后3个月以及末期随访生活质量情况两组均呈现上升趋势,且研究组生活质量评分上升情况显著优于对照组,差异有统计学意义(P<0.05)。结论脑室腹腔分流术中运用腹腔气腹穿刺术取得的手术疗效与传统的脑室腹腔分流术手术疗效相似,同时术后并发症方面,行脑室腹腔分流术的患者发生率更低,该术式更能促进术后生活质量的提高,且在术中操作存在微创、简便以及安全,手术的成功率较高,造成瘢痕较小等优点。

Objective To explore the application value of intraperitoneal pneumoperitoneum puncture in ventriculo-peritoneal shunt. Methods The clinical data of 60 patients undergoing ventriculo-peritoneal shunt in our hospital from May 2016 to May 2017 were selected as the subjects. The patients were divided into control group and study group according to random distribution method, with 30 cases in each group. The patients in the control group underwent traditional surgical method during the operation. The study group was treated with intraperitoneal pneumoperitoneum puncture.The results of imaging examination, complications and quality of life after surgery were analyzed and compared between the two groups. And the practical application value of pneumoperitoneum puncture technique was explored. Results There was significant difference in symptom relief during imaging examination between the two groups at 4 weeks after surgery（P〈0.05）. Within six months, the incidence of complications in the study group was significantly lower than that of the control group, with statistically significant difference（P〈0.05）. There was no statistically significant difference in quality of life assessment between the two groups before surgery. There was an upward trend in the quality of life at 1 week after surgery, 3 months after surgery, and in the end-stage follow-up. And the increase in the quality of life score of the study group was significantly better than that of the control group, with statistical significance difference（P〈0.05）. Conclusion The curative effect of abdominal cavity pneumoperitoneum puncture in the ventriculo-peritoneal shunt is similar to that of the traditional ventriculo-peritoneal shunt. At the same time, the incidence of postoperative complications is lower in patients undergoing ventriculo-peritoneal shunt. It can promote the improvement of postoperative quality of life better, and has advantages of minimal invasivion, simple and safe in operation, and high success rate of surgery and small scar.