老年正常压力脑积水17例临床评估与治疗回顾性分析

Clinical evaluation and treatment of 17 cases of senile normal pressure hydrocephalus

目的回顾性分析17例老年正常压力脑积水患者临床资料,进行临床评估和治疗效果分析。方法对17例老年正常压力脑积水患者的临床资料汇总分析,测算Evans指数,对比分析脑脊液放液前后步态障碍和认知障碍的动态变化,对比分析脑室腹腔分流术前后临床系统评分动态变化。结果Evan指数为0.360±0.045;腰穿脑脊液放液后10 m直线行走测试和MMSE评分,8 h开始出现好转,24 h达高峰,48 h接近基线;脑室腹腔分流术后,INPHGS值和改良Rankin值,均有明显下降;Pearson相关分析,患者病程与MMSE评分呈负相关性,与步态障碍、INPHGS评分和改良Rankin评分呈正相关。结论老年正常压力脑积水病程越长,症状越重,脑室腹腔分流术后症状改善明显。

Objective To evaluate the treatment of normal pressure hydrocephalus(NPH)via analysis of the clinical data of 17 elderly patients with NPH.Methods The clinical data of 17 elderly patients with NPH were collected and analyzed.The Evans index(EI)was calculated;the dynamic changes of gait and cognitive impairment before and after lumbar puncture were compared;and the dynamic changes of clinical system score before and after cerebrospinal fluid shunt were compared.Results The EI was 0.360±0.045.Eight hours after lumbar puncture and cerebrospinal fluid drainage,the 10 meter linear walking test and MMSE score began to improve,and peaked at 24 hours and approached the baseline at 48 hours.After cerebrospinal fluid shunt,both INPHGS value and modified Rankin value significantly decreased.Pearson analysis showed that the course of disease was negatively correlated with MMSE score,and positively correlated with gait disorder,INPHGS score and modified Rankin score.Conclusion The longer the course of NPH in the elderly,the more severe were the symptoms.The symptoms significantly improve after cerebrospinal fluid shunt.