不同穿刺点脑室-腹腔分流术对继发交通性脑积水患者的效果及并发症发生率对比分析
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安徽省高校自然科学研究项目(2023AH053299);


Comparative analysis of effects and incidence rates of complications of ventriculoperitoneal shunt at different puncture points in patients with sec-ondary communicating hydrocephalus
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    目的:对比分析不同穿刺点脑室-腹腔分流术治疗继发交通性脑积水的效果及并发症发生情况。方法:122例行脑室-腹腔分流术治疗的继发交通性脑积水患者,根据手术穿刺点不同分为额角组(采用经侧脑室额角穿刺,n=57)和枕角组(采用经侧脑室枕角穿刺,n=65)。比较两组患者手术相关指标、术前及术后1周认知功能[格拉斯哥昏迷评分(GCS)]和并发症发生情况。结果:两组患者手术时间、术中出血量、住院时间、二次手术调整率比较,差异无统计学意义(P>0.05)。额角组患者术后分流管位置良好率高于枕角组(P<0.05);并发症总发生率低于枕角组(P<0.05)。术前、术后当日及术后1周,两组患者GCS评分均无统计学差异(P>0.05)。结论:经侧脑室额角及枕角穿刺脑室-腹腔分流术均能改善继发交通性脑积水患者的认知功能,但经额角穿刺能有效提高术后分流管位置良好率,降低并发症发生率,值得应用推广。

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    Objective:To compare the effects and complications of ventriculoperitoneal shunt at different puncture points in the treatment of secondary communicating hydrocephalus.Methods:The clinical data of 122 patients with secondary communicating hydro-cephalus were retrospectively analyzed.According to different surgical methods,the patients were divided into 57 cases in frontal horn group(puncture via frontal horn of lateral ventricle)and 65 cases in occipital horn group(puncture via occipital horn of lateral ventri-cle).The surgical related indicators,preoperative and 1-week postoperative cognitive function[Glasgow Coma Scale(GCS)]and inci-dence rates of complications were compared between the two groups of patients.Results:There were no significant differences in surgical time,intraoperative blood loss,hospitalization time and adjustment rate of secondary surgery between groups(P>0.05).The good rate of postoperative shunt tube position in frontal horn group was higher than that in occipital horn group(P<0.05).The total incidence rate of complications in frontal horn group was lower compared to occipital horn group(P<0.05).No obvious difference was observed in GCS score between groups before surgery and on the day and about 1 week after surgery(P>0.05).Conclusion:Both surgical methods can improve the cognitive function of patients.Compared with ventriculoperitoneal shunt through occipital horn puncture for pa-tients with secondary communicating hydrocephalus,frontal horn puncture can more effectively enhance the good rate of postoperative shunt tube position and reduce the incidence rates of complications,it is worthy of application and promotion.

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金将;陈为为;.不同穿刺点脑室-腹腔分流术对继发交通性脑积水患者的效果及并发症发生率对比分析[J].川北医学院学报,2025,40(6):770-773.

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  • 在线发布日期: 2025-07-09
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