采用脑室冲洗进行脑脊液置换在脑脊液异常的脑积水患者脑室腹腔分流术中的应用效果  

Effect of cerebrospinal fluid replacement with ventricular flushing applied to ventriculo-peritoneal shunt in hydrocephalus patients with abnormal cerebrospinal fluid

作　　者：向迅捷[1] 徐才邦 孙留中 黄华[1] 庞鸣琰 冉江 沈曲 XIANG Xun-jie;XU Cai-bang;SUN Liu-zhong;HUANG Hua;PANG Ming-yan;RAN Jiang;SHEN Qu(Department of Neurosurgery,Jiangbin Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西壮族自治区江滨医院神经外科,南宁市530021

出　　处：《广西医学》2020年第5期559-561,共3页Guangxi Medical Journal

基　　金：广西医疗卫生适宜技术研究与开发项目(S201556)。

摘　　要：目的探讨采用脑室冲洗进行脑脊液置换在脑脊液异常的脑积水患者脑室腹腔分流术中的应用效果。方法将60例脑脊液异常的脑积水患者随机分成观察组和对照组,每组30例。观察组患者行脑室穿刺后,采用脑室冲洗进行脑脊液置换,对照组患者行脑室外引流或腰大池外引流,两组均待脑脊液蛋白浓度<500 mg/L后行脑室腹腔分流术。比较两组患者术前、术后7 d、术后14 d的脑脊液蛋白含量及等待分流手术时间,观察两组患者治疗及随访期间颅内感染发生率、分流管堵管发生率。结果两组患者的脑脊液蛋白含量差异无统计学意义(P>0.05)。观察组等待分流时间短于对照组(P<0.05),但颅内感染发生率、分流管堵管发生率差异均无统计学意义(均P>0.05)。结论采用脑室冲洗进行脑脊液置换是一种行之有效的缩短脑脊液异常的脑积水患者等待脑室腹腔分流手术时间的方法,且不会增加患者颅内感染及分流管堵管的发生率。Objective To explore the effect of cerebrospinal fluid replacement with ventricular flushing applied to ventriculo-peritoneal shunt in hydrocephalus patients with abnormal cerebrospinal fluid. Methods Sixty hydrocephalus patients with abnormal cerebrospinal fluid were randomly divided into observation group and control group, with 30 cases in each group. Patients in the observation group received ventricular puncture prior to cerebrospinal fluid replacement with ventricular flushing, whereas patients in the control group received extraventricular drainage or external lumbar cistern drainage, ventriculo-peritoneal shunt was performed in the two groups at the concentration of cerebrospinal fluid protein of less than 500 mg/L. The contents of cerebrospinal fluid protein before operation, 7 days and 14 days after operation, along with waiting duration to shunt surgery, were compared between the two groups, and the incidence rates of intracranial infection and shunt plugging were observed in both groups during treatment and follow-up period. Results The content of cerebrospinal fluid protein showed no statistically significant difference between the two groups(P>0.05).The observation group had shorter waiting duration to shunt surgery than the control group(P<0.05), but there was no statistically significant difference between the two groups in incidence rate of intracranial infection or shunt plugging(all P>0.05).Conclusion Cerebrospinal fluid replacement with ventricular flushing is an effective method for shortening the waiting duration to ventriculo-peritoneal shunt surgery in hydrocephalus patients with abnormal cerebrospinal fluid, which dose not increase the incidence rate of intracranial infection or shunt plugging.

关 键 词：脑脊液置换 脑脊液异常脑积水 脑室冲洗 脑室腹腔分流术 脑室外引流 腰大池外引流 脑脊液蛋白 手术时间 

分 类 号：R651.1[医药卫生—外科学]