腰大池-腹腔分流术治疗特发性颅内压增高症的效果  

Efficacy of lumboperitoneal shunt for idiopathic intracranial hypertension

作　　者：赵尚峰[1] 张家亮[1] 李永[1] 吴江平[1] 刘浩成[1] 孙思[1] 王卫[1] 马建民 王佳伟[3] 康军[1] Zhao Shangfeng;Zhang Jialiang;Li Yong;Wu Jiangping;Liu Haocheng;Sun Si;Wang Wei;Ma Jianmin;Wang Jiawei;Kang Jun(Department of Neurosurgery,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Department of Ophthalmology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Department of Neurology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院神经外科,100730 [2]首都医科大学附属北京同仁医院眼科,100730 [3]首都医科大学附属北京同仁医院神经内科,100730

出　　处：《眼科》2020年第4期255-259,共5页Ophthalmology in China

摘　　要：目的观察腰大池-腹腔分流术(lumboperitoneal shunt,LPS)治疗特发性颅内压增高症(idiopathic intracranial hypertension,IIH)的有效性和安全性。设计回顾性病例系列。研究对象北京同仁医院IIH行LPS手术的患者114例。方法回顾患者LPS术前、术后的病历资料。平均随访(3.4±1.2)个月(2~16个月)。主要指标最佳矫正视力(BCVA)、视野、视乳头水肿程度、头痛程度以及术后并发症。结果术前BCVA<0.05者62例(59.6%),术后3个月30例(28.8%)(P=0.000)。视野缺损术后改善66例(70.2%)。术前视乳头轻度水肿58例(50.9%),重度水肿25例(21.9%);术后3个月视乳头轻度水肿54例(47.4%),重度水肿7例(6.1%)。头痛术后3个月缓解67例(93.1%)。术后分流管阻塞3例,感染2例。随访期间分流管调整12例,平均调整1.4次。结论短期随访结果显示,LPS术能有效改善IIH患者的视力、视野、头痛症状和视乳头水肿程度。Objective To evaluate the efficacy and safty of lumboperitoneal shunt(LPS)for treatment of idiopathic intracranial hypertension(IIH).Design Retrospective case series.Participant 114 IIH patients with LPS from Beijing Tongren Hospital.Methods The medical records of patients before and after LPS surgery were reviewed.The patients were followed up for 3.4±1.2(2-16)months.Main Outcome Measures Best corrected visual acuity(BCVA),visual field,papilledema,headache and complications.Results 62 cases(59.6%)with preoperative BCVA<0.05 reduced to 30 cases(28,8%)after LPS(P<0.05).66 cases(70.2%)of visual field defect were improved.Mild papilledema occurred in 58 cases(50.9%)before LPS,and severe papilledema in 54 cases(47.4%),while 25 cases(21.9%)remained with mild papilledema,and 7 cases(6.1%)with severe papilledema after LPS.Headache in 67 cases(93.1%)alleviated 3 months after LPS.During the follow-up period,shunt obstruction developed in 3 cases and shunt infection in 2 cases postoperatively.12 cases underwent shunt adjustments,with an average of 1.4 times.Conclusion The short-term follow-up in this study showed that LPS can effectively relieve the visual acuity,visual field,headache and papilledema caused by IIH.

关 键 词：特发性颅内压增高症 腰大池-腹腔分流术 

分 类 号：R651.1[医药卫生—外科学]