改良脑室-心房分流术治疗脑积水(附20例分析)  

Modified ventricle-right atrium shunt for treatment of hydrocephalus: analysis of 20 cases

作　　者：王志刚[1] 张纪庆[2] 丁璇[2] 冀勇[2] 曲春城[1] 张庆林[2] 

机构地区：[1]华中科技大学同济医学院附属协和医院神经外科,湖北武汉430022 [2]山东大学第二医院神经外科,山东济南250033

出　　处：《中国微侵袭神经外科杂志》2007年第8期344-346,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨改良脑室-心房(V-A)分流术在脑室-腹腔(V-P)分流术失败的脑积水病人中的应用价值。方法对20例多次行V-P分流术失败的病人应用颈内静脉穿刺术,通过8F导管鞘将V-A分流管引至右心房,实现V-A分流术。结果一次操作成功19例(95%);另1例调整分流管心房端后分流通畅。随访时间2～20个月,平均8个月;头颅CT复查均见脑室明显回缩,病人临床症状消失,恢复日常生活及工作,均达临床治愈。结论对于行V-P分流术失败的病人应积极改行V-A分流术。改良V-A分流术是一种微创治疗方法,不影响局部血液循环,操作方法简便,恢复快,无明显并发症。Objective To explore the value of modified ventricle-right atrium （V-A） shunt in the hydrocephalus patients whose ventriculoperitoneal （V-P） shunt failed. Methods Twenty hydrocephalus patients undergoing several failed V-P shunts were operated on by V-A shunt. The internal carotid vein was punctured, and the shunt tube was sent to the right atrium through the 8F catheter sheath. Results The minimally invasive surgery in improving V-A shunt succeed in 19 cases （95%）. The shunt fistula of right atrium was adjusted then unblocked in 1 case. The follow-up period ranged from 2 to 20 months, mean 8 months. The ventricle obviously shrank in the head CT, the clinical manifestations of the patients disappeared, and all the patients went back to the daily life and returned to work. Conclusion The patients who failed in the V-P shunt should be operated on by V-A shunt actively. The improved method is a minimally invasive method, which has no influence on regional blood circulation, with simple operation, quick recovery, and no obvious complications.

关 键 词：脑积水 脑室腹膜分流术 脑室心房分流术 

分 类 号：R651.1[医药卫生—外科学]