腹腔镜辅助下脑室-腹腔分流术治疗脑积水的临床研究

Clinical study of laparoscopic assisted ventriculoperitoneal shunt for hydrocephalus

目的:比较腹腔镜辅助下脑室-腹腔分流术和传统脑室腹腔分流术治疗脑积水的疗效。方法:收治脑积水患者54例,分为腹腔镜组28例和传统手术组26例,统计分析两组疗效和术后并发症情况,并对两组远期生活质量(Karnofasy)进行评分。结果:腹腔镜手术组发生颅内感染1例,无分流管阻塞、腹部伤口愈合不良、腹腔脏器损伤情况发生。而常规手术组分别发生分流管阻塞1例,腹部伤口愈合不良1例,颅内感染2例,腹腔脏器损伤1例,差异有统计学意义(P<0.05)。结论:相对于传统脑室腹腔分流术,腹腔镜辅助下脑室-腹腔分流术治疗脑积水更安全可靠,具有恢复快、创伤小、术后并发症少等优点,具有较好的临床应用前景。

Objective:To compare the efficacy and postoperative complications between laparoscopic-assisted ventriculoperitoneal shunt and conventional ventriculoperitoneal shunt for hydrocephalus.Methods:54 patients with hydrocephalus were selected, they were divided into the laparoscopic group(with 28 cases)and the traditional operation group(with 26 cases).The efficacy and postoperative complications of the two groups were analyzed statistically.The long-term quality of life(Karnofasy score)of the two groups was also evaluated.Results:In the laparoscopic group,intracranial infection occurred in 1 case,no shunt obstruction,abdominal wound healing,abdominal organ injury,while in the conventional group,shunt obstruction occurred in 1 case,abdominal wound healing was poor in 1 case,intracranial infection in 2 cases,and abdominal cavity injury in 1 case,the difference between the two groups was statistically significant(P<0.05).Conclusion:Compared with traditional ventriculoperitoneal shunt,laparoscopic assisted ventriculoperitoneal shunt is safer and more reliable in the treatment of hydrocephalus.It has the advantages of quick recovery, less trauma,less postoperative complications,and has a better clinical application prospect.