腹腔镜辅助下暂时性长程脑室外引流术治疗创伤性脑损伤后脑积水的疗效分析  

Effect of laparoscopic temporary long tunneled external ventricular drainage on hydrocephalus after traumatic brain injury

作　　者：常明涛 陈建发 覃夏 谢奎龙 杨华 Chang Mingtao;Chen Jianfa;Qin Xia;Xie Kuilong;Yang Hua(Department of General Surgery,Naval First Hospital of the Southern Theater Command,Zhanjiang 524009,China)

机构地区：[1]南部战区海军第一医院普外科,广东湛江524009 [2]南部战区海军第一医院神经外科,广东湛江524009

出　　处：《海军医学杂志》2025年第3期292-296,共5页Journal of Navy Medicine

摘　　要：目的 比较创伤性脑损伤(TBI)后脑积水患者接受腹腔镜辅助下暂时性长程脑室外引流术和传统腹腔镜辅助下脑室-腹腔分流术的临床疗效。方法 回顾性分析2018年10月至2021年10月,南部战区海军第一医院收治的52例TBI后脑积水患者作为研究对象,按随机数字表法分为腹腔镜辅助下暂时性长程脑室外引流术组(外引流组)和腹腔镜辅助下脑室-腹腔常规分流组(常规组),每组26例。比较2组患者的置管手术操作时间、颅内高压症缓解时间、住院时间、治疗有效率和不良反应发生率等。结果 外引流组的治疗总有效率(92.31%)高于常规组(80.77%),差异有统计学意义(P<0.05)。外引流组的置管手术操作时间长于常规组,但是前者的颅内高压症缓解时间和平均住院时间等均低于常规组,差异有统计学意义(P<0.05)。常规组出现的颅内感染、分流管阻塞、腹部切口愈合等不良反应发生率(19.23%)高于外引流组(7.69%),差异有统计学意义(P<0.05)。结论 腹腔镜辅助下暂时性长程脑室外引流术治疗TBI后脑积水的疗效更好,建议在临床治疗中优先选用。Objective To compare the clinical effect between laparoscopic temporary long tunneled external ventricular drainage and traditional laparoscopic ventriculoperitoneal shunt in patients with hydrocephalus after traumatic brain injury(TBI).Methods A total of 52 patients who underwent laparoscopic temporary long tunneled external ventricular drainage(external drainage group)or traditional laparoscopic ventriculoperitoneal shunt(traditional shunt group)for hydrocephalus after TBI from October 2018 to October 2021 were retrospectively analyzed.The catheterization time,remission time of intracranial hypertension,average hospital stay,therapeutic effective rate and the incidence of complications were compared between the two groups.Results The total effective rate of the external drainage group was significantly higher than that of the traditional shunt group(92.31%vs 80.77%,P<0.05).The external drainage group had longer catheterization time and shorter remission time of intracranial hypertension and average hospital stay than the traditional shunt group.The incidence of adverse reactions such as intracranial infection,shunt obstruction and poor healing in the traditional shunt group was significantly higher than that in the external drainage group(19.23%vs 7.69%,P<0.05).Conclusion Laparoscopic temporary long tunneled external ventricular drainage can achieve better therapeutic effect for hydrocephalus after TBI,and it is recommended in clinical treatment.

关 键 词：创伤性脑损伤 脑积水 脑室-腹腔分流术 腹腔镜 

分 类 号：R742.2[医药卫生—神经病学与精神病学]