脑室-腹腔分流术治疗结核性脑膜炎并发脑积水  

Ventriculo-peritoneal shunt for hydrocephalus following tuberculous meningitis

作　　者：王代旭[1] 赵东娥[1] 陈金华[1] 金保山[1] 

机构地区：[1]华中科技大学同济医学院附属荆州医院神经外科,湖北荆州434020

出　　处：《中国临床神经外科杂志》2012年第6期344-346,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨脑室-腹腔分流术(VPS)治疗结核性脑膜炎(TBM)合并脑积水的效果。方法回顾性分析2004年1月至2010年7月行VPS治疗的15例TBM合并脑积水患者的临床资料。结果 15例患者全部行VPS,术后意识均好转、症状减轻,未发生结核性腹莫炎。术前抗结核治疗1月以上者10例,均无分流管堵塞发生;而另外5例抗结核治疗不足1月者,分流管堵塞者2例。脑脊液蛋白含量在0.5g/L以上者6例中2例堵管;脑脊液蛋白在0.5g/L以下的9例中,无堵管者。结论 VPS是治疗TBM并发脑积水的有效方法,术前最好能抗结核治疗1月以上。Objective To investigate the curative effect of ventriculo-peritoneal shunt （VPS） on hydrocephalus following tuberculous meningitis. Method Of 15 patients with hydrocephalus following tuberculous meningitis who underwent VPS from January, 2004 to July, 2010 were analyzed retrospectively, including the diagnosis, treatment, prognosis and so on. Results The consciousness was improved and no tuberculous peritonitis occurred after VPS in all the patients. There were not the block of the shunt tubes in 10 patients who received preoperative antituberculous therapy for more than a month and there were the block of shunt tubes in 2 of 5 patients who received preoperative antituberculous therapy for less than a month. The shunt tubes were blocked in 2 of 6 patients whose cerebrospinal fluid （CSF） protein content was above 0.5g/L, and no shunt tubes were blocked in 9 patients whose CSF protein content was below 0.5g/L. Conclusions VPS is an effective method to treat hydrocephalus following tuberculous meningitis. Preoperative antituberculous therapy lasting more than a month is helpful to preventing block of the shunt tube.

关 键 词：结核性脑膜炎 脑积水 脑室-腹腔分流术 

分 类 号：R742.7[医药卫生—神经病学与精神病学] R529.3[医药卫生—临床医学]