影响可调压分流管在脑室腹腔分流术术前压力设定及术后反复调压因素的分析

Analysis of Factors Influencing Pressure Setting of Adjustable Pressure Shunt before Ventricular-abdominal Shunt Operation and Repeated Pressure Adjustment after Operation

目的探究并分析影响可调压分流管在脑室腹腔分流术术前压力设定及术后反复调压的因素。方法回顾性分析2017年6月-2019年6月期间山东省千佛山医院、山东省妇幼保健院、北大医疗鲁中医院脑室腹腔引流(使用可调压分流管)患者21例,联合患者临床一般资料,对术前压力设定的依据及影响术后反复调压的因素进行分析,并总结调压效果。结果21例患者中,未再调压者为2例,调压者为19例,分析两组一般资料得出,脑积水发病时间、脑积水程度、腰穿测压是否规范、是否存在影响脑脊液分泌因素,差异有统计学意义(χ^2=5.526、4.421、4.203、7.074,P<0.05),将上述差异项目带入Logistic回归方程计算,发现以上因素均为导致术后反复调压的影响因素。结论影响患者分流管术前压力设定及术后反复调压的因素包括脑积水发病时间、脑积水程度、腰穿测压是否规范、是否存在影响脑脊液分泌因素,要求临床医师重视并设法规避上述因素,以减少术后调压次数。

Objective To explore and analyze the factors that affect the preoperative pressure setting of the ventricular-abdominal shunt and repeated pressure adjustment after the operation.Methods A retrospective analysis of 21 cases of intraventricular abdominal drainage(using adjustable pressure shunt)in Shandong Qianfoshan Hospital,Shandong Maternal and Child Health Hospital,and Peking University Medical Luzhong Hospital from June 2017 to June 2019.The combined patients were clinically common data,analyze the basis of preoperative pressure setting and the factors affecting repeated pressure adjustment after operation,and summarize the effect of pressure adjustment.Results Among the 21 patients,there were 2 patients who did not adjust the pressure again,and 19 patients who did adjust the pressure.The general data of the two groups were analyzed.The onset time of hydrocephalus,the degree of hydrocephalus,whether the lumbar puncture measurement was standardized and accurate,and whether there were factors affecting the secretion of cerebrospinal fluid.There were statistically significant differences(χ^2=5.526,4.421,4.203,7.074,P<0.05).The above difference items were brought into the Logistic regression equation to calculate.It was found that the above factors were all influencing factors that led to repeated postoperative blood pressure adjustment.Conclusion The factors that affect the pressure setting of the patient’s shunt before operation and repeated pressure adjustment after the operation include the onset time of hydrocephalus,the degree of hydrocephalus,whether the lumbar puncture measurement was standardized,and whether there were factors affecting the secretion of cerebrospinal fluid.Set rules to avoid the above factors to reduce the number of postoperative pressure adjustments.