摘要
目的 对比可调压分流管行腰大池腹腔分流（LP）与可调压分流管行脑室腹腔分流（VP）治疗创伤后脑积水效果及并发症.方法 回顾性分析我院2014年3月至2016年3月神经外科收治的创伤后脑积水患者80例,随机分为两组,其中40例行LP治疗的患者为LP组,40例行VP治疗的患者为VP组.所有患者均于1年内进行随访,调查并比较两组患者的症状改善率、神经功能缺损评分状况及并发症发生率.结果 LP组术后脑积水消失总有效率为92.50%（37/40）,VP组术后脑积水消失有效率为87.50%（35/40）,两组患者脑积水消失有效率差异无统计学意义（χ2=0.556,P=0.456）;LP组治疗前神经功能缺损评分（28.35±8.64）分,VP组治疗前神经功能缺损评分（29.13±7.98）分,两组患者治疗前神经功能缺损评分差异无统计学意义（t=0.419,P=0.676）;LP组治疗后神经功能缺损评分（19.32±5.34）分,VP组治疗后神经功能缺损评分（21.62±4.86）分,两组数据比较差异无统计学意义（t=1.480,P=0.143）,两组患者治疗后神经功能缺损平均得分明显优于治疗前（t值分别为5.623、5.084,P均〈0.001）;两组患者治疗前、后的尿失禁改善平均得分差异无统计学意义（t值分别为0.376、1.265,P均〉0.05）,LP组与VP组患者治疗后尿失禁改善平均得分明显优于治疗前（t值分别为4.891、5.370,P〈0.001）;LP组患者出血、感染、分流管相关并发症及分流异常的发生率均为2.50%（1/40）,总的并发症发生率为10.00%,VP组出血、感染、分流管相关并发症及分流异常的发生率分别为7.50%（3/40）、10.00%（4/40）、5.00%（2/40）、10.00%（4/40）,总并发症发生率为32.50%,两组比较有统计学意义（χ2=6.050,P=0.014）.结论 LP与VP治疗创伤后脑积水方面均有显著疗效,但1年后LP并发症总发生率明显低于VP,值得广泛推广到临床中.
Objective To compare the effects and complications of lumboperitoneal shunt （ LP ） and ventriculoperitoneal shunt （ VP ） in the treatment of post？traumatic hydrocephalus. Methods Eighty patients with post？traumatic hydrocephalus treated in the neurosurgery department of Zhangjiagang Hospital of Traditional Chinese Medicine from March 2014 to March 2010 were retrospectively analyzed. The patients were randomly divided into two groups,40 patients treated with LP were assigned into the LP group and 40 patients undergone VP treatment were seen as the VP group. All patients were followed up for 1 year to investigate and compare the symptom improvement rate,neurological deficit score and the incidence of complication of the two groups. Results The total effective rate of hydrocephalus disappearance in the LP group was 41. 50% （ 37/40） and 87. 50%（ 35/40） in the VP group. The difference between the two groups was not statistically significant （χ2=0. 556,P=0. 456）;the neurological deficit scores before treatment in the LP group and VP group were （28. 35±8. 64） points and （29. 13±7. 98） points,there was no significant difference between the two groups （t=0. 419,P=0. 676） . The difference in the scores of neurological deficit after treatment in the LP and VP group was not statistically significant （ （19. 32±5. 34） points vs. （21. 62±4. 86） points,t=1. 480,P=0. 143）,the average scores of neurological deficits in the two groups were significantly better than those before treatment （ t=5. 623, 5. 084,P〈0. 001 ） . There was no significant difference in the average score of improvement of urinary incontinence between the two groups before and after treatment （ t=0. 376,1. 265,P〉0. 05） ,the average score of urinary incontinence improvement after treatment in both groups were better than those before treatment （ t=4. 891,5. 370,P〈0. 001） . In the LP group,the incidence of bleeding,infection,shunt related complications and shunt abnormality were all 2. 50% （ 1/40 ） , the overall complication rate was 10. 00%, the incidence of bleeding,infection,shunt related complications and shunt abnormality in the VP group were 7. 50% （3/40）, 10% （ 4/40 ） , 5% （ 2/40 ） 10%, （ 4/40 ） , the overall complication rate was 32. 50%, there was significant difference between the two groups （χ2=6. 050,P=0. 014） . Conclusion LP and VP have significant curative effect on the treatment of post？traumatic hydrocephalus,but the overall incidence of LP complication after 1 year is significantly lower than that of VP,and is worth popularizing widely in clinical practice
作者
陆明
何卫春
闻峰
王欢景
郭春华
Lu Ming He Weichun Wen Feng Wang Huanjing Guo Chunhua(Department of Neurosurgery , Zhangfiagang Hospital of Traditional Chinese Medicine, Zhangjiagang 215600, China)
出处
《中国综合临床》
2017年第9期839-843,共5页
Clinical Medicine of China
关键词
腰大池腹腔分流
脑室腹腔分流
脑积水
疗效
并发症
Lumboperitoneal shunt
Ventriculoperitoneal shunt
Hydrocephalus
Effect
Complication
