脉络丛烧灼术联合腰大池腹腔分流术治疗感染所致难治性脑积水  

Choroid plexus cauterization for refractory hydrocephalus caused by infection

作　　者：郝晓伟[1] 范波[1] 杨晋生[1] 张鸿日[1] HAO Xiaowei;FAN Bo;YANG Jinsheng;ZHANG Hongri(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China)

机构地区：[1]河南科技大学第一附属医院,河南洛阳471003

出　　处：《中国实用神经疾病杂志》2020年第10期867-871,共5页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨脉络丛烧灼术联合腰大池腹腔分流术(L-P)对感染所致的难治性脑积水患者的治疗作用。方法对53例感染所致的难治性脑积水患者的临床资料进行回顾性分析,均实施脉络丛烧灼术,其中有25例(A组)实施脑室腹腔(V-P)分流术,余28例(B组)实施L-P分流术。对比不同时刻神经功能缺损程度评分、临床效果、并发症发生率和分流管重置率。结果NIHSS评分时间和交互对比差异均有统计学意义(P<0.05);2组术后1周、2周和1个月NIHSS评分均低于术前,术后2周和1个月NIHSS评分均低于术后1周,差异均有统计学意义(P<0.05),各时刻2组间对比差异均无统计学意义(P>0.05);2组临床效果分布及总有效率对比差异均无统计学意义(P>0.05);B组并发症发生率和分流管重置率均低于A组,差异均有统计学意义(P<0.05)。结论脉络丛烧灼术联合L-P分流术治疗感染所致的难治性脑积水患者不仅可减轻神经功能缺损程度,达到确切疗效,还可减少并发症和分流管重置。Objective To explore the therapeutic effect of choroid plexus cauterization combined with lumbar cistern peritoneal(L-P)shunt on refractory hydrocephalus caused by infection.Methods The clinical data of 53 patients with refractory hydrocephalus caused by infection were analyzed retrospectively.Choroid plexus cauterization was performed in all patients.Among them,25 patients underwent ventriculoperitoneal(V-P)shunt,which was recorded as group A.The other 28 cases were treated with L-P shunt,which was recorded as group B.The neurological deficit scores at different moments,clinical effect,complication rates and shunt reset rates were compared.Results There were significant differences in NIHSS scoring between moments and interaction(P<0.05).The NIHSS scores of the two groups at 1 week,2 weeks and 1 month after operation were lower than those before operation,which in the two groups at 2 weeks and 1 month after operation were lower than those at 1 week after operation,and the differences were statistically significant(P<0.05).There was no statistical significance between the two groups at any moment(P>0.05).There was no significant difference in clinical effect distribution and total effective rates between the two groups(P>0.05).The incidence of complications and the replacement rate of shunt in group B were lower than those in group A,and the differences were statistically significant(P<0.05).Conclusion Choroid plexus cauterization combined with L-P shunt in the treatment of refractory hydrocephalus caused by infection can not only reduce the degree of neurological deficit,achieve the exact effect,but also reduce complications and shunt reset.

关 键 词：脉络丛烧灼术 腰大池腹腔分流术 感染 难治性脑积水 脑室腹腔分流术 

分 类 号：R742.7[医药卫生—神经病学与精神病学]