反麦氏点入路对脑室-腹腔分流术后腹腔端堵管调管术疗效观察

Therapeutic effect observation of anti-McBurney point approach for enterocoelia shunt blocking after ventriculoperitoneal shunt surgery

目的评估反麦氏点入路对脑室-腹腔分流术后腹腔端堵管的疗效.方法回顾性分析解放军总医院第一医学中心神经外科自2014年5月至2018年5月收治的11例脑积水行脑室-腹腔分流术后引流管腹腔端堵管患者的临床资料,通过重新开腹将引流管腹腔端从反麦氏点放置至腹腔,观察术后患者引流管腹腔端通畅情况.结果11例患者均临床症状缓解,复查头CT显示脑室系统有不同程度的缩小,腹部X光片显示引流管位于盆腔.6个月复查均无临床症状复发.结论反麦氏点入路使分流管固定位于盆腔,避免大网膜结构包裹,未再发生堵管.反麦氏点入路可以作为腹腔端堵管调整引流管的腹腔位置手术入路.

Objective To access the curative effect of anti-McBurney point approach for enterocoelia shunt blocking after ventriculoperitoneal shunt surgery. Methods The clinical data of 11 patients treated by the first Medical Center of PLA General Hospital from May 2014 to May 2018 were analyzed retrospectively. Those cases which had enterocoelia shunt blocking after ventriculoperitoneal shunt surgery were re-operated to place shunt into enterocoelia by anti-McBurney point approach. The patency of the abdominal cavity of the patient’s drainage tube after operation was observed. Results All the 11 cases had clinical symptom remission, Reexamination of head CT revealed varying degrees of shrinkage in the ventricular system. Abdominal X-ray showed the drainage tube in the pelvic cavity. No clinical symptoms recurred after 6 months. Conclusion The anti-McBurney point approach fixed the shunt tube in the pelvic cavity, avoided the omentum structure envelopment, and did not block the tube again. The anti-McBurney point approach can be used as a surgical approach to adjust the drainage tube.