腹腔镜侧脑室经腹腔暂时性外引流治疗脑积水临床疗效分析  

Clinical analysis of laparoscopic ventriculoperitoneal shunt with temporary external drainage in the treatment of 36 patients with hydrocephalus.

作　　者：陈建发[1] 陈引香[1] 朱红胜[2] 何强华[2] 王松青[2] 傅明[1] 李萍[1] 

机构地区：[1]中国人民解放军第四二二中心医院普外科,广东湛江524009 [2]中国人民解放军第四二二中心医院神经外科,广东湛江524009

出　　处：《海南医学》2012年第21期61-63,共3页Hainan Medical Journal

摘　　要：目的探讨腹腔镜侧脑室经腹腔暂时性外引流术治疗脑积水的临床疗效。方法对近4年来采用腹腔镜侧脑室经腹腔暂时性外引流术治疗36例脑积水患者的临床资料进行回顾性分析。结果本组病例全部置管成功,无手术死亡。术后每日脑脊液引流量100～1000ml,平均(420±67.2)ml。外引流管完全拔管时间3～10d,平均(5.2±4.6)d。术后1周全部病例均行颅脑CT复查,结果提示:脑室较术前明显缩小28例(77.8%),较术前稍缩小7例(19.4%),无明显变化1例(2.8%)。术后随访3个月,治疗有效35例,有效率达97.2%。术后出现分流术相关并发症4例。结论腹腔镜侧脑室经腹腔暂时性外引流术治疗脑积水可避免术后早期因腹腔内压变化影响分流效果。该术式引流确切,置管准确,观察直接,而且操作便捷,为脑积水的治疗提供一种疗效可靠的治疗新途径。Objective To investigate the clinical efficacy of laparoscopic ventriculoperitoneal shunt with temporary external drainage in the treatment of 36 patients with hydrocephalus. Methods The clinical data of 36 patients of hydrocephalus who have been treated with laparoscopic ventriculoperitoneal shunt with temporary external drainage in the past 4 years were analyzed retrospectively. Results Laparoscopic ventriculoperitoneal shunt with temporary external drainage was performed successfully in all the patients with no death. Daily drainage volume of cerebrospinal fluid was 100～1 000 ml, （420±67.2） ml in average, and extubation time was 3～10 days, （5.2±4.6） in average. Brain CT scans were performed in all patients 7 days after operation. The sizes of cerebral ventricle decreased evidently after operation in 28 cases, mildly in 7 cases and unchanged in 1 case. During the 3-month follow-up, 35 of 36 cases （97.2%） were effective with postoperational complications in 4 cases. Conclusion Laparoscopic ventriculoperitoneal shunt with temporary external drainage benefits the prevention of the adverse effect of intra-abdominal pressure on ventriculoperitoneal shunt in the early period after operation, which is possibly a new effective measure in the treatment of hydrocephalus.

关 键 词：脑积水 侧脑室-腹腔分流术 腹腔内高压 腹腔镜 治疗 

分 类 号：R742.7[医药卫生—神经病学与精神病学]