腹腔镜下脑室腹腔分流术治疗脑积水的临床对比研究  

Comparative study on treating hydrocephalus with ventriculo-peritoneal cavity shunting by laparoscope with conventional laparotomy

作　　者：李忠[1] 张东昌[1] 郭春良[1] 张赛[2] 

机构地区：[1]武警医学院附属医院普通外科,天津300162 [2]武警医学院附属医院神经外科,天津300162

出　　处：《武警医学院学报》2007年第4期414-416,共3页Acta Academiae Medicinae CPAPF

摘　　要：【目的】总结电视腹腔镜下侧脑室-肝膈间隙分流术与常规开腹侧脑室-腹腔分流术的疗效对比。【方法】回顾性分析2004年6月—2006年6月收治的70例脑积水患者,其中腹腔镜治疗组34例,常规手术组36例。【结果】腹腔镜组分流管腹腔端梗阻发生率为8.82%,开腹手术组梗阻发生率为30.56%(P<0.05)两组间有显著差异。术后感染率分别为2.9%和2.7%。(χ2=0.002,P>0.05),χ2检验无显著差异。随访调查karnofsky评分,腹腔镜治疗组(72.58±12.08),开腹手术组(65.15±15.58),两组间有显著差异(P<0.05)。排气时间腹腔镜组和开腹手术组分别为(1.60±0.21)d和(3.40±0.26)d,两组有显著差异(P<0.05)。平均腹部手术时间腹腔镜组为(8.56±1.05)min,开腹组为(30.36±5.98)min,两组间有显著差异(P<0.05)。【结论】腹腔镜下侧脑室肝膈分流术治疗脑积水并发症少,是一种安全有效、值得推广的治疗方法。[Objective] To compare the therapeutic effect of hydrocephalus by laparoscope with routine open ventriculoperitoneal cavity shunting. [Methods] A total of 70 cases of hydrocephalus treated from June 2004 to June 2006 we retrospectively reviewed. Laparoscope operation group 34 cases and 36 cases by routine open operation group. [Results] The obstruction rate of shut tube on the tip of abdominal cavity was 8.82% in laparoscope group and in open group was 30.56% （ χ^2 = 5.16, P〈0.05）. The infection rate was 2.9% and 2.7% （ χ^2 = 0.002, P 〉 0.05）. The karnofsky score mean was （72.58 ± 12.08） and （65.15 ± 15.18） respectively （ P 〈 0.05）. Deflation time was （1.60 ± 0.21） day in laparoscope group and in open group was （3.40± 0.26） day （ P 〈 0.05）. Operation time on abdominal region was （8.56 ± 1.05） minutes and （30.36 ± 5.98） minutes respectively （ P 〈 0.05）. [Conclusions] The ventriculoperitoneal cavity shunting by laparoscope has fewer comphcations and is a safe and effective method . It deserves to spread for treating hydrocephalus.

关 键 词：脑积水 腹腔镜 脑室-腹腔分流术 治疗 

分 类 号：R651.1[医药卫生—外科学]