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不同侧脑室穿刺位置行脑室-腹腔分流术治疗脑积水的临床对比研究

A comparative study on the treatment of hydrocephalus by ventriculoperitoneal shunt at different lateral ventricle puncture locations
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摘要 目的探究与分析不同侧脑室穿刺位置行脑室-腹腔分流术治疗脑积水的临床效果及对预后的影响。方法回顾性分析我院自2017年5月~2020年5月收治的103颅脑损伤术后脑积水患者的临床资料,按照不同侧脑室穿刺的位置分为观察组(n=47)与对照组(n=56),观察组给予经侧脑室额角穿刺,耳前路径操作,对照组给予传统的侧脑室枕角穿刺,耳后路径操作,对比两组围术期指标、治疗前后脑室周围水肿带直径、脑脊液蛋白质及脑脊液红细胞水平、术后并发症发生率及格拉斯哥预后量表(Glasgow Outcome Scale,GOS)评分。结果与对照组比较,观察组手术时间及住院时间均较短、术中出血量较少、术后并发症发生率较低、预后结局较好;观察组治疗后与对照组治疗后比较脑室周围水肿带直径缩小、脑脊液蛋白质水平较低、脑脊液红细胞水平较高,差异有统计学意义(P<0.05)。结论经侧脑室额角穿刺,耳前路径操作治疗颅脑损伤术后脑积水的围术期指标表现较好,术后并发症发生率较低,整体预后较好。 Objective To explore and analyze the clinical effect and prognosis of ventriculoperitoneal shunt in the treatment of hydrocephalus at different lateral ventricle puncture locations.Methods Clinical data of 103 patients with post-traumatic hydrocephalus treated in our hospital from May 2017 to May 2020 were retrospectively analyzed.According to different locations of lateral ventricle puncture,they were divided into observation group(n=47)and control group(n=56).The observation group was given lateral ventricle frontal angle puncture and preauricular path operation,while the control group was given traditional lateral ventricle occipital angle puncture and posterior auricular path operation.The perioperative indexes,periventricular edema band diameter before and after treatment,cerebrospinal fluid protein and cerebrospinal fluid red blood cell levels,postoperative complication rate and Glasgow Outcome Scale(GOS)score were compared between the two groups.Results Compared with the control group,the operation time and hospital stay in the observation group were shorter,the intra-operative blood loss was less,the incidence of postoperative complications was lower,and the prognosis was better.After treatment,the diameter of periventricular edema band was reduced,the level of cerebrospinal fluid protein was lower,and the level of cerebrospinal fluid red blood cell was higher in the observation group compared with the control group,and the differences were statistically significant(P<0.05).Conclusion The perioperative indexes of hydrocephalus after craniocerebral injury are better,the incidence of postoperative complications is lower,and the overall prognosis is better.
作者 葛鑫 胡婕 GE Xin;HU Jie(Operating Room,The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)
出处 《哈尔滨医科大学学报》 CAS 2024年第4期367-370,共4页 Journal of Harbin Medical University
关键词 脑室-腹腔分流术 脑积水 颅脑损伤 侧脑室额角穿刺 侧脑室枕角穿刺 ventriculoperitoneal shunt hydrocephalus craniocerebral injury lateral ventricle frontal angle puncture lateral ventricle occipital angle puncture
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