脑室-腹腔分流术后分流系统堵塞(6例报告并文献复习)  

Shunt system obstruction after ventriculoperitoneal shunt(report of 6 cases and review of literature)

作　　者：惠卫宁[1] 邵国平[1] 褚荣涛[1] 黄炜[1] 龚铭杰[1] 李健[1] 王洁[1] HUI Wei-ning;SHAO Guo-ping;CHU Rong-tao(Department of Neurosurgery,Changshu No.2 People’s Hospital,Changshu 215500,China)

机构地区：[1]常熟市第二人民医院神经外科,常熟215500

出　　处：《临床神经外科杂志》2021年第4期453-456,共4页Journal of Clinical Neurosurgery

基　　金：江苏省卫生计生委2015年医改试点单位科研课题(YG201505)。

摘　　要：目的探讨脑室-腹腔分流术后分流系统堵塞的原因及防治措施。方法回顾性分析6例脑室-腹腔分流术后出现分流管堵塞患者的临床资料,并对相关文献进行复习。结果本组6例患者中,分流管脑室段堵塞2例,其中1例患者的导管被脉络丛包裹,予以重置脑室段导管和更换阀门;1例患者系导管内腔堵塞,予以更换脑室段导管和阀门。单纯阀门堵塞1例,脑室段分流管与阀门脱落后阀门堵塞1例,这2例患者均予以更换阀门。腹腔段分流管腹腔段在颞部皮下折叠1例,予以调整分流管位置,消除折叠;腹腔段导管被大网膜包裹1例,予以松解粘连,并剪除被包裹部分导管。所有患者经上述处理,分流系统均恢复通畅,脑积水表现明显好转。结论脑室-腹腔分流术后分流管在其行程中的任何部位均可能发生堵塞,准确分析判断堵管的原因及位置是妥善处理堵管的关键。Objective To investigate the causes and prevention of shunt system obstruction after ventriculoperitoneal shunt.Methods The clinical data of 6 patients with shunt obstruction after ventriculoperitoneal shunt were retrospectively analyzed,and the related literature was reviewed.Results Among the 6 patients,there were 2 cases with ventricular segment obstruction of shunt tube,in which the catheter of one patient was wrapped by choroid plexus,and the ventricular segment catheter and valve were replaced.The catheter and valve of ventricular segment were replaced in one patient because of the obstruction of catheter lumen.The valve was blocked in 1 case only,and the valve was blocked in 1 case after the ventricular shunt tube and valve fell off.The abdominal shunt was folded subcutaneously in temporal region in 1 case,and the position of shunt was adjusted to eliminate the folding.In one case,the abdominal duct was wrapped by omentum,the adhesions were released,and the wrapped part of the duct was cut off.After the above treatment,the shunt system of all patients recovered and the hydrocephalus performance improved significantly.Conclusions After ventriculoperitoneal shunt,the shunt tube may be blocked at any part of its journey.Accurate analysis of the cause and location of the obstruction is the key to deal with the blockage properly.

关 键 词：脑室-腹腔分流术 分流系统 堵塞 

分 类 号：R651[医药卫生—外科学]