老年特发性正常压力性脑积水VP分流术的效果及影响因素分析  

Efficacy and Influencing Factors of Ventriculoperitoneal Shunt in Elderly Idiopathic Normal Pressure Hydrocephalus

作　　者：孙拯 刘彦廷 罗然[1] 陈健[1] 万志先[1] 田春雷[1] Sun Zheng;Liu Yanting;Luo Ran;Chen Jian;Wan Zhixian;Tian Chunlei(Department of Neurosurgery,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University&Institute of Neurology,China Three Gorges University,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院[宜昌市中心人民医院]神经外科&三峡大学神经病学研究所,湖北宜昌443003

出　　处：《巴楚医学》2022年第1期44-48,共5页Bachu Medical Journal

基　　金：国家自然科学基金项目(No:81701278)。

摘　　要：目的:探讨脑室腹腔分流术(VP分流术)对老年特发性正常压力性脑积水(INPH)的疗效及影响因素。方法:回顾性分析我科2010年1月~2018年5月收治的78例老年INPH患者的临床资料。采用单因素和多因素Logistic回归分析患者手术效果的影响因素。结果:78名INPH患者中,VP分流术后1年内,步态障碍改善54例(69.23%),认知改善48例(61.54%),小便失禁改善24例(30.77%)。年龄<65岁、女性、步态障碍病程<25月的患者术后症状改善较好(均P<0.05)。多因素Logistic回归分析显示,步态障碍病程<25月是患者预后的独立影响因素(P<0.05)。结论:VP分流术是治疗老年INPH的有效方法,步态障碍持续时间越短分流效果越好。Objective:To investigate the efficacy and influencing factors of ventriculoperitoneal(VP)shunt in elderly idiopathic normal pressure hydrocephalus(INPH).Methods:The clinical data of 78 elderly patients with INPH admitted to our department from January 2010 to May 2018 were retrospectively analyzed.Univariate and multivariate logistic regression analysis were used to explore the influencing factors of surgical outcomes in patients.Results:There were 54 cases(69.23%)had improved gait disturbance,48 cases(61.54%)had improved cognition,and 24 cases(30.77%)had improved urinary incontinence among 78 INPH patients within 1 year after VP shunt.Postoperative symptom improvement was better in female patients less than 65 years old,with course of gait disorder less than 25 months(all P<0.05).Multivariate Logistic regression analysis showed that the duration of gait disorder less than 25 months was an independent factor for prognosis(P<0.05).Conclusion:VP shunt is an effective treatment for INPH in the elderly,and a short duration of gait disturbance indicates a good shunt effect.

关 键 词：特发性正常压力性脑积水 脑室腹腔分流 老年人 

分 类 号：R651.1[医药卫生—外科学]