腰大池腹腔与脑室-腹腔分流术治疗交通性脑积水的疗效比较  

Comparison of the efficacy of lumbocisterna peritoneal shunt and ventriculoperitoneal shunt in the treatment of communicating hydrocephalus

作　　者：华伟燕 黄臣 苏畅 HUA Weiyan;HUANG Chen;SU Chang(Lishui People's Hospital,Zhejiang 323000,China)

机构地区：[1]浙江省丽水市人民医院,丽水323000

出　　处：《浙江创伤外科》2025年第1期16-18,共3页Zhejiang Journal of Traumatic Surgery

摘　　要：目的 比较腰大池腹腔分流术(LPS)与脑室-腹腔分流术(VPS)治疗交通性脑积水的疗效和安全性。方法 回顾性分析2020年10月至2023年10月在本院进行治疗的76例交通性脑积水患者的临床资料,按照不同分流术式分为41例VPS组与35例LPS组。比较两组术后1个月的临床疗效,Barthel指数及简易智力状态检查量表(MMSE),及并发症(癫痫、感染、分流管堵塞、过度引流等)发生率。结果术后1个月,VPS组与LPS组总有效率分别为97.56%与97.14%,差异无统计学意义(P>0.05)。术前,两组Barthel指数、MMSE评分比较无差异(P>0.05),术后1个月,两组Barthel指数、MMSE评分均增加,VPS组Barthel指数、MMSE评分分别为(88.16±5.70)分、(26.75±3.11)分,与LPS组的(89.43±5.42)分、(27.04±3.04)分比较,差异无统计学意义(P>0.05)。但LPS组并发症发生率为2.86%,明显低于VPS组的17.07%,差异有统计学意义(P<0.05)。结论 VPS与LPS在交通性脑积水治疗中的手术效果相当,均能有效改善患者的智能状态及日常生活能力,但LPS并发症较少,可能在安全性方面更有优势。Objective To compare the efficacy and safety of lumbocisternoceliac shunt(LPS)and ventriculoperitoneal shunt(VPS)in the treatment of communicating hydrocephalus.Methods The clinical data of 76 patients with communicating hydrocephalus treated in our hospital from October 2020 to October 2023 were retrospectively analyzed and divided into VPS group(41 cases)and LPS group(35 cases)according to different shunt methods.The clinical efficacy,Barthel index and Mini-Mental State Examination(MMSE),and the incidence of complications(epilepsy,infection,shunt blockage,excessive drainage,etc.)were compared between the two groups one month after surgery.Results One month after operation,the total effective rate of VPS group and LPS group was 97.56%and 97.14%,with no significant difference(P>0.05).Before surgery,there was no difference in Barthel index and MMSE score between the two groups(P>0.05),one month after surgery,Barthel index and MMSE score increased between the two groups,and Barthel index and MMSE score in the VPS group were(88.16±5.70)points and(26.75±3.11)points,compared with LPS group(89.43±5.42)scores and(27.04±3.04)scores,there was no statistical significance(P>0.05).While the complication rate of LPS group was 2.86%,which was significantly lower than that of VPS group(17.07%),with statistical significance(P<0.05).Conclusion The surgical effect of VPS and LPS in the treatment of communicating hydrocephalus is similar,and both can effectively improve the patients'mental state and daily living ability,but LPS has fewer complications,and may have more advantages in safety.

关 键 词：脑积水 腰大池腹腔分流术 脑室-腹腔分流术 疗效 

分 类 号：R651.1[医药卫生—外科学]