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,i NPH)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i NPH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。
Objective To compare the efficacy and safety of lumboperitoneal shunt( LPS) and ventriculoperitoneal shunt( VPS) for patients with idiopathic normal pressure hydrocephalus( i NPH).Methods 96 patients with i NPH 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 was54. 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 i NPH,while LPS can avoid cerebral parenchymal hemorrhage caused by ventricular puncture.
作者
陈晓巍
陈治军
谢腾
刘平非
罗小程
许强华
丁锐
CHEN Xiaowei;CHEN Zhijun;XIE Teng(Department of Neurosurgery,Jingmen NO.1 People’s Hospital,Hubei,Jingmen 448000,China)
出处
《临床外科杂志》
2019年第1期45-47,共3页
Journal of Clinical Surgery
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
idiopathic normal pressure hydrocephalus
lumboperitoneal shunt
ventriculoperitoneal shunt
