临床外科杂志 ›› 2019, Vol. 27 ›› Issue (1): 45-47.doi: 10.3969/j.issn.1005-6483.2019.01.013

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腰大池腹腔分流术与脑室腹腔分流术治疗特发性正常压力脑积水的临床疗效及安全性研究

  

  1. 湖北省荆门市第一人民医院神经外科
  • 出版日期:2019-01-20 发布日期:2019-01-20

The efficacy and safety of lumboperitoneal shunt(LPS)and ventriculoperitoneal shunt(VPS)for patients with idiopathic normal pressure hydrocephalus

  1. Department of Neurosurgery,Jingmen NO.1 People’s Hospital,Hubei,Jingmen 448000,China
  • Online:2019-01-20 Published:2019-01-20

摘要: 目的 比较腰大池腹腔分流(lumboperitoneal shunt,LPS)与脑室腹腔分流(ventriculoperitoneal shunt,VPS)治疗特发性正常压力脑积水(idiopathic normal pressure hydrocephalus,iNPH)的临床疗效和安全性。方法 特发性正常压力脑积水并行分流手术病人96例,按术式分为行腰大池腹腔分流术组(LPS组)和脑室腹腔分流术组(VPS组),LPS组28例,VPS组68例。比较两组病人治疗前后临床症状、预后评分及并发症发生率。结果 治疗后LPS组和VPS组步态不稳分别为60.0%和63.5%,认知障碍分别为54.2%和57.9%,尿失禁分别为44.4% 和47.7%,两组比较差异均无统计学意义(P>0.05);LPS组和VPS组改良Rankin量表(modified Rankin Scale,mRS)评分分别为(-0.9±0.5)和(-1.0±0.9),两组比较差异无统计学意义(P>0.05)。LPS组和VPS组并发症发生率分别为17.9%和16.2%,两组比较差异无统计学意义(P>0.05)。结论 LPS和VPS治疗iNPH的疗效和安全性相似,但LPS可以避免脑室穿刺造成的脑实质出血。

关键词: 特发性正常压力脑积水, 腰大池腹腔分流, 脑室腹腔分流

Abstract: Objective To compare the efficacy and safety of lumboperitoneal shunt(LPS)and ventriculoperitoneal shunt(VPS)for patients with idiopathic normal pressure hydrocephalus(iNPH).Methods 96 patients with iNPH were retrospectively analyzed.Twentyeight patients were treated with LPS(goup LPS) and 68 cases treated with VPS(group VPS).The clinical symptom,modified Rankin Scale(mRS)score and postoperative complications were compared.Results The improvement of symptoms for group LPS and VPS,were as follows:gait disorder was 60.0% versus 63.5%,dementia was 54.2% versus 57.9%,and urinary inconvenience was 44.4% versus 47.7%(all P>0.05),respectively.The improvements of modified Rankin Scale(mRS)for group LPS and VPS were(-0.9±0.5)versus(-1.0±0.9)(P>0.05).The proportion of patients experienced postoperative complications were no significant difference between group LPS and VPS(17.9% vs.16.2%,P>0.05).Conclusion The efficacy and safety rates of group LPS are comparable to those of group VPS in the treatment of patients with iNPH,while LPS can avoid cerebral parenchymal hemorrhage caused by ventricular puncture.

Key words: idiopathic normal pressure hydrocephalus, lumboperitoneal shunt, ventriculoperitoneal shunt

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