腹腔镜辅助下脑室-腹腔分流术治疗老年人脑积水的疗效及安全性评估  

Clinical efficacy and safety of laparoscopically assisted ventriculoperitoneal shunting for the treatment of hydrocephalus in older adult patients

作　　者：鲍宁 蔚强[2] 孙宇飞 Bao Ning;Wei Qiang;Sun Yufei(Department of Neurosurgery,Yiwu Fuyuan Private Hospital,Yiwu 322000,Zhejiang Province,China;Department of Neurosurgery,Baotou City Central Hospital,Baotou 014040,Inner Mongolia Autonomous Region,China)

机构地区：[1]义乌復元私立医院神经外科,义乌322000 [2]包头市中心医院神经外科,包头014040

出　　处：《中国基层医药》2022年第12期1789-1793,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨腹腔镜辅助下脑室-腹腔(V-P)分流术治疗老年人脑积水的临床疗效及安全性。方法选取义乌復元私立医院2017年6月至2019年12月收治的老年脑积水患者64例,采用随机数字表法分为研究组和对照组,每组32例。对照组予开腹V-P分流术治疗,研究组予腹腔镜辅助下V-P分流术治疗,比较两组治疗前后Fugl-Meyer运动功能评分、日常生活能力(ADL)评分、脑积水分级评分,治疗优良率及并发症发生率。结果研究组治疗后Fugl-Meyer运动功能评分[(77.05±18.54)分]、ADL评分[(84.83±17.75)分]均高于对照组[(63.25±16.18)分、(63.76±15.04)分],差异均有统计学意义(t=3.17,P=0.002;t=5.12,P<0.001);研究组治疗后脑积水分级评分[(3.77±2.41)分]低于对照组[(6.61±2.75)分],差异有统计学意义(t=4.39,P<0.001)。研究组治疗优良率为93.75%(30/32),高于对照组的75.00%(24/32),差异有统计学意义(χ^(2)=4.26,P<0.05)。研究组并发症发生率为9.38%(3/32),低于对照组的40.63%(13/32),差异有统计学意义(χ^(2)=8.33,P<0.05)。结论腹腔镜辅助下V-P分流术可对导管位置精确定位,治疗老年人脑积水的效果更佳,可加速患者神经功能恢复,且安全性高。Objective To investigate the clinical efficacy and safety of laparoscopically assisted ventriculoperitoneal shunting for the treatment of hydrocephalus in older adult patients.Methods Sixty-four older adult patients with hydrocephalus who received treatment in Yiwu Fuyuan Private Hospital from June 2017 to December 2019 were included in this study.They were randomly divided into study and control groups,with 32 patients in each group.The control group was given ventriculoperitoneal shunting and the study group was given laparoscopically assisted ventriculoperitoneal shunting.The Fugl-Meyer assessment of motor recovery,the activity of daily life score,hydrocephalus grading score,excellent and good efficacy rate,and incidence of complications were compared between the two groups.Results After treatment,the Fugl-Meyer score and activity of daily life score in the study group were(77.05±18.54)points and(84.83±17.75)points,which were significantly higher than(63.25±16.18)points and(63.76±15.04)points in the control group(t=3.17,P=0.002;t=5.12,P<0.001).Hydrocephalus grading score in the study group was significantly lower than that in the control group[(3.77±2.41)points vs.(6.61±2.75)points,t=4.39,P<0.001].Excellent and good efficacy rate in the study group was significantly higher than that in the control group[93.75%(30/32)vs.75.00%(24/32),χ^(2)=4.26,P<0.05].The incidence of complications in the study group was significantly lower than that in the control group[9.38%(3/32)vs.40.63%(13/32),χ^(2)=8.33,P<0.005].Conclusion Laparoscopically assisted ventriculoperitoneal shunting can accurately locate the catheter and is more effective in the treatment of hydrocephalus in older adult patients compared with ventriculoperitoneal shunting.It can accelerate the recovery of neurological function and is highly safe.

关 键 词：腹腔镜检查 脑室腹膜分流术 神经外科手术 脑积水 老年人 

分 类 号：R651.1[医药卫生—外科学]