LP与VP治疗非梗阻性脑积水围术期指标对比及其对患者近远期预后影响  

Effects of LP and VP on perioperative indexes,clinical efficacy and long-term prognosis in non-obstructive hydrocephalus

作　　者：周霞 李雨倩 杨前美 ZHOU Xia;LI Yu-qian;YANG Qian-mei(Department of Neurosurgery,West China Shangjin Branch,Sichuan University,Chengdu 611730,Sichuan,China)

机构地区：[1]四川大学华西上锦分院神经外科,四川成都611730

出　　处：《川北医学院学报》2023年第3期407-410,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨非梗阻性脑积水腰大池-腹腔分流术(LP)与脑室-腹腔分流术(VP)治疗围术期指标、患者近远期预后的差异。方法:根据术式不同将102例非梗阻性脑积水患者分为LP组(n=47)和VP组(n=55),LP组采用LP治疗,VP组采用VP治疗。对比两组围术期指标,近期预后指标:术后6个月治疗总有效率、功能恢复情况[加拿大神经病学量表(CNS)评分、改良Rankin量表(mRS)评分、生活质量综合评定问卷-74(GQOLI-74)评分]及并发症发生情况;远期预后指标:术后随访24个月,观察随访期间两组预后良好率。结果:LP组患者的手术时间、术后下床时间和住院时间均较VP组缩短(P<0.05);术后6个月,LP组治疗总有效率、CNS评分、mRS评分均与VP组无统计学差异(P>0.05);LP组GQOLI-74各项评分及总分均高于VP组(P<0.05);LP组患者并发症总发生率低于VP组(6.38%vs.23.64%,P<0.05);随访24个月,LP组预后良好率高于VP组(85.11%vs.67.27%,P<0.05)。结论:LP与VP治疗非梗阻性脑积水患者疗效相当,但LP在缩短手术时间和住院时间、降低术后并发症发生率及改善生活质量、远期预后方面更优。Objective:To compare the differences in perioperative indexes,clinical efficacy and long-term prognosis between lumbar-peritoneal shunt(LP)and ventriculo-peritoneal shunt(VP)in non-obstructive hydrocephalus.Methods:A total of 102 patients with non-obstructive hydrocephalus were enrolled as the research objects.According to different surgical methods,they were divided into LP group(n=47)and VP group(n=55).The perioperative indexes,total response rate of treatment,functional recovery[scores of Canadian Neurological Scale(CNS),Modified Rankin Scale(mRS)and generic quality of life inventory-74(GQOLI-74)]at 6 months after surgery,and occurrence of complications were compared between the two groups.All were followed up for 24 months after surgery to observe the good prognosis rates in both groups during follow-up.Results:The operation time,postoperative leaving bed time and hospitalization time in LP group were shorter than those in VP group(P<0.05).At 6 months after surgery,there was no significant difference in total response rate of treatment,CNS score and mRS score between the two groups(P>0.05).The scores and total score of GQOLI-74 s in LP group were significantly higher than those in VP group(P<0.05).The total incidence of complications in LP group was lower than that in VP group(6.38%vs.23.64%,(P<0.05).After 24 months of follow-up,good prognosis rate in LP group was higher than that in VP group(85.11%vs.67.27%,P<0.05).Conclusion:The curative effect of LP and VP is comparable on patients with non-obstructive hydrocephalus.However,LP is superior in terms of shortening operation time and hospitalization time,reducing incidence of postoperative complications and improving quality of life,with better long-term prognosis.

关 键 词：非梗阻性脑积水 腰大池-腹腔分流术 脑室-腹腔分流术 疗效 并发症 

分 类 号：R742.7[医药卫生—神经病学与精神病学]