正常压力性脑积水的神经外科治疗  

The neuropsychological treatment to normal pressure hydrocephalus

作　　者：汪朝阳[1] 郑洛翰[1] 高晓英[2] 谢家斌[1] 郑佳坤[1] 林小聪[1] 蔡玮[1] 杨立业[1] 

机构地区：[1]广东省潮州市中心医院神经外科,521021 [2]广东省潮州市中心医院麻醉科,521021

出　　处：《广州医药》2010年第3期21-23,共3页Guangzhou Medical Journal

基　　金：广东省潮州市卫生局科研项目(潮卫科研200810)

摘　　要：目的探讨正常压力性脑积水的发病机理、手术指征及手术时机的合理选择。方法 46例正常压力性脑积水患者均采用脑室-腹腔分流术治疗。结果随访6个月～3年,无因分流管而引起的感染、腹膜吸收障碍、排斥反应及堵管等现象。症状明显改善生活能够完全自理(显效)及症状有所改善生活能部分自理(显效及有效)者共37例,有效率为80.43%;症状无改善且生活不能自理(无效)者共9例,无效率为19.57%。结论对正常压力性脑积水,应提高认识,尽早确诊,根据临床表现、腰穿测压及引流试验、动态颅内压监测及影像学检查,选用压力适当的分流管,力争在6个月内,及时行脑室-腹腔分流术是治疗正常压力性脑积水的理想方法。Objective To investigate the pathogenesis, operative indication and operative opportunity of NPH. Methods 46 patients of NPH were all treated with ventrieulo-peritoneal shunt （ V-P shunt） . Results Six month to three years after surgery, there were not infection, absorbing obstacle of peritonaeum, rejection and valve malfunction. 37 of the 46 shunted patients had improved to some extent and lived a complete self-help or partial self-help （excellence and utility） life. The effective power is 80. 43%. 9 of the 46 shunted patients had not any improvement and can not live a self-care life （ imefficacy） . The ratio of inefficacy is 19. 57%. Conclusion Sufficient knowledge and early diagnosis are necessary to NPH. Early treated with ventriculo peritoneal shunt （ V-P shunt） within six months is an ideal treatment to NPH. The selection of shunt tubes should according to clinical manifestation, Cerebrospinal Fluid tap test （ CSFFF）, dynamic detect of ICP （ intracranial pressure） and imaging characteristics.

关 键 词：正常压力性脑积水 脑室腹腔分流术 手术时机 分流管 

分 类 号：R651.1[医药卫生—外科学]