腰大池引流对继发性脑积水分流术疗效预判的作用  

Preoperative lumbar drain in anticipating effect of V-P shunt for secondary hydrocephalus

作　　者：刘春波[1] 王穗暖[1] 屈洪涛[1] 

机构地区：[1]苏州大学附属第三医院(常州市第一人民医院)神经外科,常州213003

出　　处：《临床神经外科杂志》2016年第1期70-71,共2页Journal of Clinical Neurosurgery

摘　　要：目的探讨脑室-腹腔分流术(V-P分流术)前行腰大池引流对继发性脑积水患者预后的提前判断。方法回顾性分析30例继发性脑积水行腰大池引流患者的临床资料,对患者腰大池引流前后的临床表现、格拉斯哥昏迷量表(glasgow coma scale,GCS)评分、影像学表现及预后进行分析。结果本组患者中脑外伤术后16例、脑出血术后10例、脑肿瘤术后2例、矢状窦血栓形成2例,均出现脑积水,均行腰大池引流。引流后减压窗凹陷者14例,患者引流前后GCS评分均无明显变化;18例引流时间超过1周者额角指数下降,脑室周围水肿减轻。结论腰大池引流可作为继发性脑积水V-P分流疗效的一种提前预判方法。Objective To explore the lumbar drain to early judgment of prognosis of patients with secondary hydrocephalus before the ventriculoperitoneal shunt. Methods The clinical data of 30 patients with secondary hydrocephalus underwent the lumbar drain were analyzed retrospectively. The clinical manifestation,GCS,imaging findings,and informations about the discharging from hospital before and after the lumbar drain were analyzed and summaried. Results Of 30 patients,16 were trauma brain injury after operation,10 intracranial hemorrhage after operation,2 brain tumor after operation and 2 superior sagittal sinus thrombosis with hydrocephalus,all patients underwent the lumbar cistern drainage. 14 cases decompression window depressed after drainage,no obvious change in GCS,18 cases of drainage time more than 1 week gain eminence index fell and ventricle surrounding edema reduced.Conclusion The lumbar drainage can be used as a kind of anticipation of secondary hydrocephalus with V-P shunt and this method is simple,safely,effective and can be popularized in clinic.

关 键 词：脑室-腹腔分流术 脑积水 腰大池引流 

分 类 号：R651.1[医药卫生—外科学]