腹腔镜脑室-腹腔分流术治疗梗阻性脑积水的疗效分析  

Efficacy analysis of laparoscopic ventricle-peritoneal shunt in the treatment of obstructive hydrocephalus

作　　者：龚良[1] 钱忠心[1] 叶树铭[1] 赵鸿[1] 刘向阳[1] 郑佳佳[1] GONG Liang;QIAN Zhong-xin;YE Shu-ming(Department of Neurosurgery,Punan Hospital of Shanghai,Shanghai 200125,China)

机构地区：[1]上海市浦东新区浦南医院神经外科,上海200125

出　　处：《腹腔镜外科杂志》2021年第9期703-706,共4页Journal of Laparoscopic Surgery

基　　金：上海市医学重点专科建设(神经外科)(ZK2019C07);上海市浦东新区高原学科(PWYGy2018-04);上海市卫生和计划生育委员会科研课题(201740305)。

摘　　要：目的:探讨腹腔镜侧脑室-腹腔分流术治疗梗阻性脑积水的临床价值。方法:选择2015年1月至2019年12月收治的44例梗阻性脑积水患者,随机分为腹腔镜组(腹腔镜侧脑室-腹腔分流术,n=22)与开腹组(开腹手术,n=22),比较两组腹部手术时间、分流管腹腔端置管准确率、术后并发症(分流管堵塞、感染)发生率、术后远期(6~12个月)生活质量评分(Karnofsky评分)。结果:腹腔镜组腹部手术时间短于开腹组,并发症发生率低于开腹组,分流管腹腔端置管准确率高于开腹组,差异均有统计学意义(P<0.05);腹腔镜组远期生活质量高于开腹组,差异有统计学意义(P<0.001)。结论:腹腔镜侧脑室-腹腔分流术后并发症少,对患者远期生活质量具有良好的改善作用。Objective:To explore the clinical value of laparoscopic lateral ventricle-peritoneal shunt in the treatment of noncommunicating hydrocephalus.Method:From Jan.2015 to Dec.2019,44 patients of noncommunicating hydrocephalus were selected and randomly divided into laparoscopic group(22 cases of laparoscopic lateral ventricle-peritoneal shunt)and open group(22 cases of laparotomy).The abdominal surgery time,the placement accuracy of shunt tube in abdominal cavity,the incidence of postoperative complications(shunt tube blockage,infection)and the long-term(6-12 months)quality of life Karnofsky score were compared between the two groups.Results:The abdominal surgery time of the laparoscopic group was significantly shorter than that of the open group,the incidence of complications was significantly lower than that of the open group,the placement accuracy of shunt tube in abdominal cavity was significantly higher than the open group,the differences were statistically significant(P<0.05).The long-term quality of life in laparoscopic group was better than that in open group,and the difference was statistically significant(P<0.001).Conclusions:Laparoscopic lateral ventricle-peritoneal shunt not only causes fewer postoperative complications,but also positively improves the long-term quality of life.It is an effective method for treating hydrocephalus in neurosurgery,and it is worthy of clinical promotion.

关 键 词：脑积水 侧脑室-腹腔分流术 腹腔镜检查 疗效比较研究 

分 类 号：R742.7[医药卫生—神经病学与精神病学]