脑室-心房分流术治疗多次脑室-腹腔分流术失败后脑积水  

Ventriculoatrial shunt for treatment of hydrocephalus after failures of previous multiple ventriculoperitoneal shunts

作　　者：李嵌嵌 詹升全[1] 郭文龙[1] 王鹏[1] 李炎稳[1] 周东[1] 

机构地区：[1]广东省人民医院神经外科,广州510080

出　　处：《中国临床神经外科杂志》2014年第5期278-279,282,共3页Chinese Journal of Clinical Neurosurgery

基　　金：广东省科技计划项目(2011B061300055)

摘　　要：目的探讨脑室心房分流术(VAS)治疗多次脑室腹腔分流术(VPS)失败后脑积水的临床疗效。方法回顾性分析我院2001年1月至2011年12月收治的47例既往多次行VPS失败后改行VAS患者的临床资料。结果 VAS后1周、1个月、3个月、6个月、1年、3年有效率分别为94%(44/47)、87%(41/47)、77%(36/47)、72%(34/47)、68%(32/47)、64%(30/47)。VAS后发生分流管堵塞14例,感染3例,引流过度2例;并发症发生率为40.4%(19/47)。因分流失败需要再次手术的比例占36.2%(17/47)。结论多次VPS失败后改行VAS,术后短期效果明显,但因各种并发症导致再手术率无降低。Objective To investigate the clinical curative effect of ventriculoatrial shunt （VAS） on hydrocephalus after previous multiple ventriculoperitoneal shunt （VPS） failures and VAS common complications. Method The clinical data of 47 patients with hydrocephalus, who underwent VAS in our department from January, 2001 to December, 2011 after multiple previous VPS failures, were analyzed retrospectively. Results The effective rate of the 1 week, and 1, 3, 6, 12 and 36 months were 94%, 87%, 77%, 72%, 68%, 64% respectively. The main postoperative complications included catheter occlusion in 14 patients, infection in 3 and over-drainage in 2. The cumulative complication rate was 40.4% （19/47）. One patient died. VAS failure occurred in 17 patients （36.2%）, who underwent VAS once again. Conclusions The short-term curative effect of VAS on the hydrocephalus after previous multiple VPS failures is good, but long-term effect is not ideal due to high compication rate of VAS.

关 键 词：脑积水 脑室-腹腔分流术 脑室-心房分流术 疗效 

分 类 号：R742.7[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]