摘要
目的 探讨脑室腹腔分流术后脑内出血的原因及其发病机制。方法 回顾性分析3例脑室腹腔分流术后脑内出血患者的临床资料,并结合相关文献进行复习。结果 病例1在分流术后第1天发生早期脑内出血,由于出血量大,行颅内血肿清除术,病例2和3分别于分流术后第6、9天发生迟发性脑内出血,出血量较小行保守治疗。结论 分流术后早期脑内出血可能是空心导管直接穿刺损伤微小血管及血管跨壁压增加所致,而迟发性脑内出血则可能是由于各种原因所致的脑组织脆弱性及导管对微小血管的延迟侵蚀作用造成。
Objective To investigate the causes and pathogenesis of intracerebral hemorrhage secondary to ventriculoperitoneal(VP)shunt.Methods The clinical data in 3 cases of intracerebral hemorrhage after VP shunt were retrospectively analyzed and the review was performed by combining with the related literatures.Results The case 1 developed early intracerebral hemorrhage on 1 d after the shunt operation.The intracranial hematoma evacuation was performed due to the large amount of bleeding,the case 2 and case 3 developed the delayed intracerebral hemorrhage on 6 d and 9 d after shunt operation respectively and conducted the conservative treatment due to the small amount of bleeding.Conclusion Early intracerebral hemorrhage after shunt surgery may be caused by the lesion of small vessels by direct puncture of hollow catheter and vascular transmural pressure increase,while delayed intracerebral hemorrhage may be ascribed to the vulnerability of the brain tissue induced by various causes and erosive effects of catheter on microvessels.
作者
赵丹旭
刘春光
钱东
章顶立
李宏廷
张新宇
徐学君
ZHAO Danxu;LIU Chunguang;QIAN Dong;ZHANG Dingli;LI Hongting;ZHANG Xinyu;XU Xuejun(Graduate School of Zunyi Medical University,Zunyi,Guizhou 563000,China;Department of Neurosurgery,Chengdu Second People’s Hospital,Chengdu,Sichuan 610000,China;Graduate School of Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 610000,China)
出处
《重庆医学》
CAS
2023年第8期1177-1181,1187,共6页
Chongqing medicine
基金
四川省成都市科技局重大科技应用示范项目(2019-YF09-00097-SN)。
关键词
脑室-腹腔分流术
脑室内出血
发病机制
文献复习
ventriculo-peritoneal shunt
intraventricular hemorrhage
pathogenesis
literature review
