腰大池-腹腔分流术治疗脑室出血后交通性脑积水效果分析

Effect of lumbar cistern peritoneal shunt on communicating hydrocephalus after intraventricular hemorrhage

目的分析腰大池-腹腔分流(LPS)术治疗脑室出血后交通性脑积水的效果。方法抽取2014年6月至2018年5月太原钢铁(集团)有限公司总医院收治的脑室出血后交通性脑积水患者60例,按照随机数表分为两组,每组30例。研究组采取体外可调压LPS,对照组采取侧脑室-腹腔分流术(VPS)。记录并比较两组治疗效果、手术时间、住院时间、拔管时间。结果术后1年,研究组总有效率为93.3%(28/30),对照组为83.3%(25/30),两组比较差异未见统计学意义(P>0.05)。研究组手术时间、住院时间、拔管时间短于对照组,差异有统计学意义(P<0.05)。两组治疗前及治疗后NIHSS、ADL评分比较差异未见统计学意义(P>0.05);治疗后,两组NIHSS评分低于治疗前(P<0.01)。研究组并发症发生率为6.7%,低于对照组的36.7%,差异有统计学意义(P<0.01)。结论 LPS治疗脑室出血后交通性脑积水效果显著,手术时间及患者住院时间较短,术后1年并发症发生率较低。

Objective To analyze the efficacy of lumbar cistern shunt(LPS)on communicating hydrocephalus after ventricular hemorrhage.Methods Sixty patients with communicating hydrocephalus after intraventricular hemorrhage treated in Taiyuan Iron and Steel Group General Hospital from June 2014 to May 2018 were selected,and they were divided into two groups according to random number table,with 30 cases in each group,adjustable LPS was performed in the study group and lateral ventricle-peritoneal shunt(VPS)was used in the control group.The treatment effect,operation time,hospitalization time and extubation time of the two groups were recorded and compared.Results The total effective rate of the study group at 1 year after surgery was 93.3%(28/30)in the study group and that of the control group was 83.3%(25/30).There was no significant difference between the two groups(P>0.05).The operation time,hospitalization time and extubation time of the study group were shorter than those of the control group,and the differences were significant(P<0.05).There were no significant differences in National institute of health stroke scale(NIHSS)and activities of daily living(ADL)scores between the two groups before and after treatment(P>0.05);after treatment,the NIHSS scores of the two groups were lower than those before treatment(P<0.01).The incidence of complications in the study group was 6.7%,lower than 36.7%in the control group,and the difference was significant(P<0.01).Conclusions LPS has a significant effect on the treatment of communicating hydrocephalus after intraventricular hemorrhage.The operation time and the hospitalization time of the patients are shorter,and the incidence of complications after 1 year is lower.