成人Dandy-Walker综合征的手术治疗  

Surgical treatment of adult Dandy-Walker syndrome

作　　者：姚宝军[1] 王文犀[1] 卢进发[1] 张元[1] 苏玉涛[1] 王新亮[1] 

机构地区：[1]解放军第252医院神经外科,河北保定071000

出　　处：《局解手术学杂志》2017年第1期44-47,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的通过回顾性分析及文献复习,探讨成人Dandy-Walker综合征(DWS)的手术方法及疗效。方法 2010年8月至2011年8月,我院手术治疗成人DWS 3例,其中病例1行后颅窝囊肿腹腔分流术,手术采用高压普通分流管;病例2行左侧侧脑室腹腔分流术,手术采用高压普通分流管;病例3行后颅窝囊肿、左侧侧脑室腹腔分流术,手术采用高压双头分流管,双头分别置于左侧侧脑室及后颅窝囊肿内,两个头端通过三通与分流阀及腹腔端引流管相接。结果 3例患者中1例术后头痛症状未能缓解,经过按压分流阀,1个月后缓解,其他2例术后DWS症状随即消失。随访4年,3例患者DWS症状消失,无阳性体征。结论对于有症状的成人DWS患者,分流手术可以消除和改善症状,缓解后颅窝囊肿张力,且手术并发症发生率低,疗效良好。Objective To discuss the surgical method and efficacy of adult Dandy-Walker syndrome （DWS） through retrospective anal- ysis and literature review. Methods There were 3 cases of adult DWS in our hospital from August 2010 to August 2011. One case of them was given posterior cranial fossa cyst peritoneal shunt, and the surgery adopted ordinary high voltage shunt. Case 2 was given left side of the lateral ventricle peritoneal shunt, and the surgery adopted ordinary high voltage shunt. Case 3 was given posterior cranial fossa cyst peritoneal shunt combined with left side of the lateral ventricle peritoneal shunt, and the surgery adopted double-end high voltage shunt. The two ends of the shunt were respectively linked with the diverter valve and abdominal cavity drainage tube through T-branch pipe. Results Among the 3 patients, there was 1 case failed to ease the headache symptoms, and it was relieved one month later. The preoperative symptoms of the oth- el- 2 cases disappeared immediately ＇after the surgery. During the 4 years of follow-up, preoperative symptoms of the 3 patients disappeared, and there was no positive signs. Conclusion For adult patients with symptomatic DWS, shunt surgery can ehminate symptoms, relieve the tension of the posterior fossa cyst,achieve good curative effect, and there was no surgical complication.

关 键 词：DANDY-WALKER综合征 脑室腹腔分流术 脑积水 颅窝囊肿腹腔分流术 

分 类 号：R651.1[医药卫生—外科学]