神经内镜加腹腔镜辅助与常规的脑室腹腔分流术后分流系统失效率比较  

Comparison of incidence of shunt system failure between neuroendoscope-laparoscope assisted and non-endoscope-assisted ventricular-peritoneal shunt for hydrocephalus

作　　者：林发牧 许小兵 

机构地区：[1]广东省佛山市顺德区第一人民医院神经外科,528300

出　　处：《中华神经医学杂志》2014年第8期833-835,共3页Chinese Journal of Neuromedicine

摘　　要：目的 探讨神经内镜加腹腔镜综合辅助脑室腹腔分流术在降低术后分流系统失效率中的应用价值. 方法 对佛山市顺德区第一人民医院神经外科自2007年1月至2012年8月进行的141例神经内镜加腹腔镜综合辅助脑室腹腔分流术（内镜辅助组）以及自2001年1月至2006年12月进行的167例常规脑室腹腔分流术（常规组）的术后分流系统失效的发生率进行回顾性分析比较. 结果 内镜辅助组失访5例,剩余136例患者中,7例出现分流管堵塞,分流系统失效发生率为5.1％,其中发生脑室端堵塞3例,腹腔端堵塞4例,分流阀失效0例;常规组失访12例,剩余155例患者中,47例出现分流管堵塞,分流系统失效发生率为30.3％,其中发生脑室端堵塞31例,腹腔端堵塞15例,分流阀失效1例;内镜辅助组分流系统失效总发生率明显低于常规组,差异具有统计学意义（x^2=30.379,P=0.000）. 结论 采用神经内镜加腹腔镜综合辅助脑室腹腔分流术可降低脑积水术后分流系统失效的发生率.Objective To compare the incidence of shunt system failure between neuroendoscope-laparoscope assisted and non-endoscope-assisted ventricular-peritoneal shunt （VPS） for hydrocephalus.Methods A retrospective analysis was performed in the incidence of shunt system failure of 141 hydrocephalus patients accepted neuroendoscope-laparoscope assisted VPS,admitted to our hospital from January 2007 to August 2012,and 167 hydrocephalus patients with non-endoscope assisted VPS,admitted to our hospital from January 2001 to December 2006.All these patients were followed up for 1 to 72 months and the incidence rate of shunt system failure was compared between the two groups.Results Five patients failed in follow-up in patients accepted neuroendoscope-laparoscope assisted VPS; the incidence rate of shunt system failure in neuroendoscope-laparoscope assisted VPS was 5.1%,including 3 in ventricular end blockage and 4 in intraperitoneal end blockage; shunt valve was not noted.Twelve patients failed in follow-up in patients accepted neuroendoscope-laparoscope assisted VPS; the incidence rate of shunt system failure in neuroendoscope-laparoscope assisted VPS was 30.3%,including 31 in ventricular end blockage and 15 in intraperitoneal end blockage; shunt valve was noted in one patient.The incidence rate of shunt system failure in neuroendoscope-laparoscope assisted VPS was significantly lower than that in non-endoscope assisted group （x^2=30.379,P=0.000）.Conclusion In contrast to the non-endoscope assisted VPS surgery,the incidence of shunt system failure has been reduced significantly by neuroendoscope plus laparoscope assisted VPS surgery.

关 键 词：脑积水 神经内镜 腹腔镜 脑室腹腔分流术 分流系统失效 

分 类 号：R651.1[医药卫生—外科学]