脑积水诊治现状及问题

Current status and problems in diagnosis and treatment of hydrocephalus

脑积水是一种常见的原发或继发的中枢神经系统病变,常导致患者生存质量低下甚或致残致死,疾病负担沉重。该病病因复杂、机制不清、治疗困难、并发症多,是神经外科的一大挑战。造成目前现状的重要原因在于基础研究相对匮乏、对脑脊液循环机制及脑积水发生发展过程认识不足。此外,术前评估不全面和不精细,治疗方案缺乏个体化选择,术后随访不够严密和全面,也限制了临床治疗水平的提高。因此,本文结合国内外研究进展,从脑积水现状、分类与发生机制、脑脊液循环途径新发现及目前治疗状况进行述评,以期为脑积水的研究与治疗提供新思路。

Hydrocephalus is a common primary or secondary central nervous system disease,which often leads to poor quality of life or even disability and death.It is a great challenge for neurosurgery because of its complicated etiology,unclear mechanism,difficult treatment and many complications.The main reasons for the current situation lie in the lack of basic research,the lack of understanding of the mechanism of cerebrospinal fluid circulation and the occurrence and development of hydrocephalus.In addition,the preoperative evaluation is not comprehensive and precise,the treatment plan is lack of individualized choice,and the postoperative follow-up is not strict and comprehensive,which also limits the improvement of clinical treatment level.Therefore,based on the research progress at home and abroad,this paper reviews the current situation,classification and mechanism of hydrocephalus,new discovery of cerebrospinal fluid circulation pathway and current treatment status,in order to provide new ideas for the research and treatment of hydrocephalus.