脑积水脑室-腹腔分流术后迟发性脑出血临床特点和危险因素分析  

Clinical characteristics and risk factors of delayed intracranial hemorrhage after ventriculoperitoneal shunt in patients with hydrocephalus

作　　者：辛惠宁[1] 杨波[1] 魏晨斌[1] 陶剑[1] 黄绳跃[1] XIN Huining;YANG Bo;WEI Chenbin;TAO Jian;HUANG Shengyue(Department of Neurosurgery,Fujian Provincial Hospital,Fuzhou,Fujian 350001,China)

机构地区：[1]福建省立医院神经外科,福州350001

出　　处：《福建医药杂志》2022年第1期11-14,共4页Fujian Medical Journal

基　　金：福建省卫生计生中青年骨干人才培养项目(2018GZQN-2)。

摘　　要：目的探讨脑积水行脑室-腹腔分流术(VP分流术)后发生的迟发性脑出血(DICH)的临床特点和相关危险因素.方法收集我院神经外科收治脑积水行VP分流术的患者128例的临床资料,进一步分析VP分流术DICH患者的基本临床特点和危险因素.结果VP分流术后发生脑出血共14例,占比10.94%(14/128),其中6例(4.69%)为早期脑出血,8例(6.25%)为DICH.不同年龄、高血压病史、糖尿病史、颅骨缺损、术后1周内行阀门调节、气管切开合并术后肺部感染患者VP分流术后DICH发生率比较差异有统计学意义(P<0.05).结论患者高龄、高血压病史、糖尿病史、颅骨缺损、术后较早调节阀门压力、气管切开合并术后肺部感染可能是VP分流术后发生DICH的危险因素.当VP分流术患者存在上述高危因素时应密切监护,以预防及早期发现DICH的发生.Objective To analyze the clinical characteristics and risk factors of delayed intracranial hemorrhage(DICH)after ventriculoperitoneal(VP)shunt in patients with hydrocephalus.Methods Clinical data of 128 patients with ventriculoperitoneal shunt due to hydrocephalus admitted to neurosurgery department of our hospital from May 2017 to April 2020 were collected in the study.The patients were divided into DICH group and non-DICH group according to whether or not DICH occurred.The clinical characteristics and risk factors of DICH were analyzed.Results Among 128 patients.6 were early intracranial hemorrhage.8(6.25%)were DICH.There were significant differences in ages,history of hypertension,history of diabetes.skull defect,history of down-regulating shunt valve within 1 week,tracheotomy with postoperative pulmonary infection between the two groups(P<0.05).Conclusion Older age.history of hypertension and/or diabetes,skull defect and history of down-regulating shunt valve within 1 week,and tracheotomy with postoperative pulmonary infection are risk factors for the DICH after VP shunt.Patients with the above high risk factors needs close monitoring and clinical intervention for early detection and prevention.

关 键 词：脑积水 脑室-腹腔分流术 迟发性脑出血 

分 类 号：R651.1[医药卫生—外科学]