可调压分流管初始开放压力值设定的影响因素分析

Influence factors of preoperative initial open pressure value setting in programmable CSF shunt valve

目的分析脑积水患者在使用可调压分流管治疗时的影响因素,设计出量化的标准,以期为指导术前该值的设定提供参考依据。方法回顾性分析自2015年3月至2018年9月我院使用可调压分流管治疗脑积水的患者资料,设定年龄、性别、患病时长、腰穿值、术前颅骨缺损与否、原发疾病、脑积水类别和分流术式等作为影响因素,采用t检验、方差分析、相关分析探索各个变量与初始开放压力值的关系,采用多元线性回归分析建立线性回归模型。结果单因素分析中发现初始开放压力值的设定与脑积水类型、病程、年龄、是否存在颅骨缺损及不同原发疾病类型等因素有相关性,采用多元线性逐步回归方程,可以计算不同类型患者初始开放压力设定值。结论临床上通常以腰穿值作为预设压力值的重要依据,但本研究发现,上述其他因素对于初始开放压力值也有重要影响;本研究为逐步完善的线性回归模型打下了基础,进一步为临床设定可调压分流管初始开放压力值的研究提供科学而有意义的支撑数据。

Objective To analyze the influencing factors of the initial open pressure value setting in the treatment of hydrocephalus with programmable CSF shunt valve,and to provide reference for guiding the setting of the initial open pressure before operation.Methods The data of patients with hydrocephalus treated by programmable CSF shunt valve from March 2015 to September 2018 were retrospectively analyzed.Gender,age,course of disease,preoperative lumbar puncture pressure,skull defect,classification of primary disease,classification of hydrocephalus and shunt operation were included and analyzed.With descriptive statistical analysis,t-test,variance analysis and correlation analysis,different functions of each index,especially the relationship between each index with the initial open pressure value and the pressure value after the last pressure regulation were analyzed,and a linear regression model was established by multiple linear regression analysis.Results The setting of initial open pressure was correlated with the classification of hydrocephalus,age,skull defect and classification of primary disease,and multiplelinearregressione quation could be used to calculate initial open pressure value for different patients.Conclusion When setting the initial open pressure of programmable CSF shunt valve,besides lumbar puncture pressure,classification of hydrocephalus,age,skull defect and classification of primary disease are also important factors.The linear regression model established in this study can provide a reference for setting initial pressure in the future to some extent.