脑积水分流术后分流泵调压频次与临床疗效的关系研究  

Correlation between frequency of shunt pump pressure regulation and clinical efficacy after hydrocephalus shunt

作　　者：叶衍涓[1] 张欢 孙翔 何骁征[1] Ye Yanjuan;Zhang Huan;Sun Xiang;He Xiaozheng(Department of Neurosurgery,National Key Clinic Specialty,Neurosurgery Institute of Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration,Zhujiang Hospital,Southern Medical University,Guangzhou 510282,China)

机构地区：[1]国家临床重点专科,教育部工程技术研究中心,广东省脑功能修复与再生重点实验室,南方医科大学珠江医院神经外科,广州510282

出　　处：《中华神经医学杂志》2020年第10期1030-1034,共5页Chinese Journal of Neuromedicine

基　　金：广东省医学科学技术研究基金(A2015360)。

摘　　要：目的分析脑积水患者脑室-腹腔分流术后分流泵的调压频次及特点,探讨分流泵的调压频次与预后的关系。方法选择南方医科大学珠江医院神经外科自2018年1月至2018年12月行脑室-腹腔分流术的101例患者,根据患者术后调压频次高低分为未调压组、低频调压组(1~2次)和高频调压组(2次以上)。比较高压性脑积水/正常压力脑积水与调压频次的关系,调压原因与调压频次的关系,以及不同调压频次组患者预后的差异。结果101例植入可调压分流管患者中,未调压组34例,低频调压组52例,高频调压组15例。高压性脑积水患者术后低频调压、高频调压比例均高于正常压力脑积水患者,差异有统计学意义(P<0.05)。低频调压组患者调压原因中分流不足、分流过度以及磁场干扰所占比例均高于高频调压组,而高频调压组患者因分流异常而调压者所占比例显著高于术后低频调压组患者,差异具有统计学意义(P<0.05)。101例患者中疗效不佳者共7例,其中低频调压组4例,高频调压组3例。不同调压频次组患者预后良好率差异有统计学意义(P<0.05),未调压组、低频调压组及高频调压组患者预后良好率依次降低。结论66.3%的脑积水脑室-腹腔分流术后患者需要再次调压治疗,并且高频调压患者疗效不佳比例明显高于低频调压患者,临床需加以重视。Objective To observe the clinical characteristics of pressure regulation frequency of shunt pump in patients with hydrocephalus after ventriculoperitoneal shunt,and explore the correlation between frequencies of shunt pump and prognoses of these patients.Methods One hundred and one patients underwent ventriculoperitoneal shunt in our hospital from January 2018 to December 2018 were selected.According to the frequencies of postoperative pressure regulation of these patients,they were divided into non-pressure regulation group,low-frequency pressure regulation group(1-2 times)and high-frequency pressure regulation group(2 times or more).The relations of high-pressure hydrocephalus/normal pressure hydrocephalus with pressure regulation frequency,and relation between causes of pressure regulation and pressure regulation frequency were compared,and the prognoses of patients with different pressure regulation frequencies were analyzed.Results Among the 101 patients with implanted adjustable pressure shunt,34 had no pressure regulation after surgery,52 had low-frequency pressure regulation,and 15 had high-frequency pressure regulation.The percentages of patients accepted low-frequency pressure regulation and high-frequency pressure regulation in patients with high-pressure hydrocephalus were significantly higher than those with normal pressure hydrocephalus(P<0.05).The proportions of patients with insufficient shunt,excessive shunt or magnetic field interference in the low-frequency pressure regulation group were significantly higher than those in the high-frequency pressure regulation group(P<0.05),while the proportions of patients with abnormal shunt(stagger of insufficient shunt,excessive shunt)in the low-frequency pressure regulation group were significantly lower than those in the high-frequency pressure regulation group(P<0.05).There were 7 patients with poor curative effect,including 4 patients from the low-frequency pressure regulation group and 3 from the high-frequency pressure regulation group.The prognoses o

关 键 词：可调压式分流管 脑积水 脑室-腹腔分流术 调压频次 

分 类 号：R651.1[医药卫生—外科学]