脑室腹腔分流术的时机与脑积水疗效的相关性研究  

Comparative study on treatment of hydrocephalus by ventriculoperitoneal shunt at different time

作　　者：洪成 朱航 吴清 陆泓宇 刘宁[1] HONG Cheng;ZHU Hang;WU Qing;LU Hongyu;LIU Ning(Department of Neurosurgery,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院神经外科,南京210029

出　　处：《临床神经外科杂志》2024年第6期664-667,共4页Journal of Clinical Neurosurgery

基　　金：国家自然科学基金资助项目(81872058)。

摘　　要：目的 比较不同时期行脑室腹腔(VP)分流术治疗脑积水的临床效果及预后。方法 回顾性分析2022年9月-2023年8月南京医科大学第一附属医院神经外科收治的130例继发性脑积水患者的临床资料,研究不同时机手术治疗前后的格拉斯哥昏迷量表(GCS)、Barthel指数(BI)、简易智能精神状态检查量表(MMSE)的改善情况。结果 各组VP分流术后的GCS、Barthel、MMSE均有不同程度提高,具有统计学差异(P<0.05);其中0~3个月组与3~6个月组的临床效果相比无明显统计学差异,但优于6个月以上组。结论 对于颅脑损伤、脑出血、颅内肿瘤、颅内动脉瘤等患者在其术后并发脑积水的情况通过采用VP分流术进行治疗可有效提升患者的神经功能,日常生活能力和智能精神状态。手术时间主张选择在6个月以内。Objective To compare the clinical effect and prognosis of hydrocephalus underwent ventriculoperitoneal(VP)shunt at different time.Methods The clinical data of 130 patients with secondary hydrocephalus admitted to the Department of Neurosurgery,The First Affiliated Hospital of Nanjing Medical University from September 2022 to August 2023 were analyzed retrospectively.The improvement of Glasgow coma scale(GCS),Barthel index(BI),and mini mental state examination(MMSE)before and after surgical treatment at different times were studied.Results The GCS,BI and MMSE of all groups after VP shunt were significantly increased(P<0.05).Among them,there was no significant statistical difference in clinical effect between the 0-3 months group and the 3-6 months group,but it was better than the group above 6 months.Conclusions For the patients with secondary hydrocephalus after craniocerebral injury,cerebral hemorrhage,intracranial tumor and intracranial aneurysm surgery,the treatment of VP shunt can effectively improve the neurological function,daily living ability and intelligent mental state of the patients.The operation time should be within 6 months.

关 键 词：脑室腹腔分流术 脑积水 格拉斯哥昏迷评分 巴塞尔指数量表 简易智能精神状态检查量表 

分 类 号：R742.7[医药卫生—神经病学与精神病学] R651[医药卫生—临床医学]