成人脑积水术后脑室-腹腔分流管断裂的原因及处理策略(2例报告并文献复习)  

Treatment of fractured ventriculoperitoneal shunt in adults( report of 2 cases and review of literature)

作　　者：马冕 丁志良 吴刚[1] 阮文华 成之奇 邓朋 唐晓宇 吴建东[1] 

机构地区：[1]南京医科大学附属苏州市立医院本部神经外科,215000

出　　处：《临床神经外科杂志》2017年第6期469-472,共4页Journal of Clinical Neurosurgery

摘　　要：目的探讨成人脑积水术后脑室-腹腔分流管断管的原因及处理策略。方法回顾性分析2例成人脑积水术后分流管断裂患者的临床资料。并结合文献分析术后分流管系统连接中断的相关因素,以及对分流管连接中断的预防、诊断及处理方法。结果 1例患者女性,36岁;1例患者男性,33岁;分别于术后5年、3年发生断管(均在颈部活动时);主要表现为头痛及颈部包块。经腹部X线片或CT检查示,腹腔端引流管脱落。均予以腹腔镜下取出原有引流管,重新置入分流管;术后患者症状均消失。结论成人脑室-腹腔分流管连接中断的发生率低,但可导致严重的并发症。其与生长发育、颈部活动、宿主反应、分流管系统退化、手术操作、外伤等因素相关,通过X线片、CT重建、放射性核素以及手术探查等方式明确断管位置,并及时采取相应的处理。Objective To explore the causes and treatment strategies for fractured adult ventriculoperitoneal shunt systems. Methods The clinical data of 2 patients with postoperative ventriculoperitoneal shunt fractures were analyzed retrospectively. The literature on this complication were reviewed and prevention and treatment strategies were explored. Results 1 female patient was 36 years old and 1 male patient was 33 years old. Shunt tube rupture occurred 5 years and 3 years after operation respectively（ all occurred when the neck was active）. Abdominal X-ray or CT scan showed that the shunt tube fell off to the abdomen. The original shunt tube was removed under laparoscopy and re-implant shunt tube. Then the patients ＇ symptoms disappeared after operation. Conclusions The incidence of adult ventriculoperitoneal shunt pipe fracture is very low,though it is a serious complication. Many factors cause the shunt fracture,including growth,neck activity,host responses,system degradation,surgical operation and trauma. We can make broken tube positions clear by using x-ray,CT,radionuclide,and surgical exploration methods,in order to achieve long-term patient rehabilitation.

关 键 词：脑积水 脑室-腹腔分流管 连接中断 

分 类 号：R742.7[医药卫生—神经病学与精神病学]