脑室镜联合腹腔镜在脑室腹腔分流术治疗老年脑积水中的应用研究  

The application of ventriculoscopy combined with laparoscopy in ventriculoperitoneal shunt in the treatment of elderly hydrocephalus

作　　者：郭士琨[1] 

机构地区：[1]商丘市第一人民医院神经外科,476100

出　　处：《国际医药卫生导报》2016年第21期3255-3257,共3页International Medicine and Health Guidance News

摘　　要：目的探讨脑室镜联合腹腔镜辅助脑室腹腔分流术在治疗老年脑积水中的疗效及安全性。方法选取本院2013年6月至2015年3月收治的150例老年脑积水患者，根据手术治疗方式不同分为三组，每组50例。A组患者行传统脑室腹腔分流术进行治疗，B患者在腹腔镜辅助下行脑室腹腔分流术进行治疗，C组患者在脑室镜联合腹腔镜辅助下行脑室腹腔分流术进行治疗，比较三组患者的临床治疗效果及并发症发生率的差异。结果三组患者临床治疗总有效率分别为60％、80％、92％，C组与A、B组比较差异有统计学意义（P〈0．05）；C组患者分流管堵塞及术后感染发生率明显低于A、B组（P〈0．05）；B、c组患者脑实质内出血的发生率均明显低于A组（P〈0．05）。结论脑室镜联合腹腔镜辅助脑室腹腔分流术治疗老年脑积水临床疗效确切，可显著降低临床并发症的发生率，对于改善患者的预后具有积极意义。Objective To investigate the clinical efficacy and safety of ventriculoscopy combined with laparoscopy assisted ventriculoperitoneal shunt in the treatment of elderly patients with hydrocephalus. Methods 150 elderly patients with hydrocephalus in our hospital from June 2013 to March 2015 were selected as study subjects, and divided into three groups according to the different treatment methods, 50 cases in each group. Group A was treated with traditional ventrieuloperitoneal shunt, group B was treated with ventriculoperitoneal shunt assisted by laparoscopy, group C was treated with ventriculoperitoneal shunt assisted by ventriculoseopy combined with laparoscopy. Compared the treatment effect and the incidence of complications among three groups. Results The total effective rate of three groups were 60%, 80%, 92%, with statistically significant differences between group C and group A, B （P〈0.05）. The incidences of shunt tube blockage and postoperative infection in group C were significantly lower than those in group A, B （P〈0.05）, the incidence of intraeerebral hemorrhage in group B, C were significantly lower than that in group A （P〈0.05）. Conclusion Ventriculoscopy combined with laparoscopy assisted ventriculoperitoneal shunt has definite curative effect in the treatment of elderly patients with hydrocephalus, which can significantly reduce the incidence of clinical complications, with positive significance for improving the prognosis of patients.

关 键 词：脑室腹腔分流术 脑积水 脑室镜 腹腔镜 

分 类 号：R742.7[医药卫生—神经病学与精神病学]