脑室-腹腔分流管移位至心脏二例报告及文献复习  

Migration of distal catheter of ventriculoperitoneal shunt into heart： report of 2 cases and review of literature

作　　者：韦拳堂[1] 彭玉平[1] 漆松涛[1] 李伟光[1] 曾浩[1] 

机构地区：[1]南方医科大学附属南方医院神经外科,广州510515

出　　处：《中华神经外科杂志》2011年第4期451-454,共4页Chinese Journal of Neurosurgery

摘　　要：目的 探讨罕见的脑室-腹腔分流管移位至心脏的发病机制、临床特点、诊治方法及并发症.方法 分析2例脑室-腹腔分流管移位至心脏的诊治过程,并结合文献对本病的预防及诊治进行讨论.结果 通过临床表现及影像学检查明确诊断,手术顺利拔除了移位的分流管,术中及术后患者病情平稳.结论 首次在国内报道了脑室-腹腔分流管移位至心脏的病例;在脑室-腹腔分流术中注意通条打皮下隧道时不宜过深或过浅,通条头部不宜过尖;术后出现异常应复查头部CT、胸片及腹片;直接从头部原切口处切开拔除分流管是简单、可行、安全的手术方式.Objective To discuss the mechanism, clinical features, complications, diagnosis criteria and treatment of intracardiac migration of the distal catheter of ventriculoperitoneal shunt. Method The diagnosis criteria and treatment of 2 cases of intracardiac migration of the distal catheter of ventriculoperitoneal shunt were studied, and relative literatures were reviewed. Results The migratory catheter was successfully extracted after definite diagnosis according to clinical features and imaging findings. There was no postoperative abnormality. Conclusions This is the first report of migration of the distal catheter of ventriculoperitoneal shunt into heart in China.The possible measures to minimize the incidence of the migration include avoiding deep or superficial neck tunneling and using blunt tunneling devices. Head CT, chest and abdominal x - ray are needed if postoperative abnormality is noticed. Percutaneous removal of the catheter from the retroauricular fomer incision is simple and safe.

关 键 词：脑室-腹腔分流 脑积水 并发症 分流管移位 心脏 

分 类 号：R651.1[医药卫生—外科学]