不同手术路径对脑室-腹腔分流手术效果的影响  

Effect of different approaches on the surgical results of ventriculoperitoneal shunt

作　　者：杨利孙[1] 陈飞[1] 王奕鹏[1] 邵征宇[1] 姜源[1] 沈敬敬[1] 

机构地区：[1]南通瑞慈医院神经外科,江苏南通226010

出　　处：《中华神经外科疾病研究杂志》2008年第1期60-63,共4页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的探讨脑室-腹腔分流的手术路径的改进方法。方法对56例脑积水患者行脑室-腹腔分流术。根据手术路径不同,分成两组。实验组22例,采用经侧脑室额角穿刺、经耳前路径的方法。对照组34例,采用传统的侧脑室枕角穿刺、耳后路径。分析比较两组手术的治疗结果和并发症发生情况。结果术后早期CT检查,发现实验组脑室明显缩小者占86.4%,脑室内导管位置满意者占94.4%,均明显高于对照组(P<0.05)。随访期内发现,实验组导管阻塞1例(4.5%),对照组导管阻塞9例(26.5%),两组比较有显著性差异(P<0.05)。结论经侧脑室额角穿刺、经耳前路径的手术方法可能优于传统分流手术,值得临床推广应用。Objective To investigate the modification of surgical approach on ventriculoperitoneal shunt operation. Methods The ventriculoperitoneal shunt was performed on 56 case.s of hydrocephalus. According to the surgical approaches, these cases were classified into two groups, experiment group （n =22） and control group （n =34）. In experiment group, front horn puncture and the drainage catheter by an anterior ear approach was used. In control group, occipital horn puncture and the drainage catheter by a posterior ear approach was used as in traditional method. The surgical results and complications were analyzed. Results Early postoperative CT examination showed that in the experiment group ventricle volume become smaller in 86. 4% cases and good position of ventricular catheter was obtained in 94.4% cases, which were significantly higher than those in the control group （P〈0.05）. During the follow-up period, the catheter got obstructed in one case in the experiment group （4.5%）and nine cases in the control （26.5%）, which were statistically different between two groups （P 〈0.05）. Conclusion The method of front horn puncture with anterior ear approach is superior to the traditional shunt operation. It deserves to be used widely in clinical practice.

关 键 词：脑室-腹腔分流 手术路径 脑积水 额角穿刺 耳前路径 

分 类 号：R651.1[医药卫生—外科学]