CAJ | 학술논문

目的探讨可调压分流管治疗先天性颅内静脉回流异常所致脑积水的应用价值.方法 2例男性患儿行CT、MRI提示脑室系统扩张,MRV及DSA检查发现颅内静脉窦广泛闭塞.腰穿压力显著升高.手术均采用强生可调压分流管行脑室-腹腔体外可调压分流术治疗.结果 2例患者术中均将分流阀压力设定为200 mmH2O,术后逐步调低,调低至180 mmH2O均出现不同程度低颅压症状,调高后症状缓解,2例患者术后智力及运动功能显著提高,复查CT提示脑室减小.结论先天性颅内静脉异常回流导致的高颅压性脑积水非常少见,治疗经验甚少.可调压分流显然是治疗颅内静脉回流导致高颅压性脑积水一种最佳治疗方法,对压力调节,需通过较长时间多次调节来逐步达到一个合适的个体压力.
목적 탐토가조압분류관치료선천성로내정맥회류이상소치뇌적수적응용개치.방법 2례남성환인행CT、MRI제시뇌실계통확장,MRV급DSA검사발현로내정맥두엄범폐새.요천압력현저승고.수술균채용강생가조압분류관행뇌실-복강체외가조압분류술치료.결과 2례환자술중균장분류벌압력설정위200 mmH2O,술후축보조저,조저지180 mmH2O균출현불동정도저로압증상,조고후증상완해,2례환자술후지력급운동공능현저제고,복사CT제시뇌실감소.결론 선천성로내정맥이상회류도치적고로압성뇌적수비상소견,치료경험심소.가조압분류현연시치료로내정맥회류도치고로압성뇌적수일충최가치료방법,대압력조절,수통과교장시간다차조절래축보체도일개합괄적개체압력.
Objective To investigate the value of Codman Hakim pressure - adjustable shunt in the treatment of hydrocephalus associated with congenital intracranial anomalous venous return.Methods 2 patients whose diagnosis were confirmed by CT,MRI,MRV and DSA and programmable ventriculoperitoneal shunting was given.Results The pressure of 2 cases of patients undergoing shunt valve was set to 200 mmH2O in operation and the pressure was reduce gradually.The patients developed symptoms of low intracranial pressure in different degrees when the pressure was reduced to 180 mmH2O.The symptoms were alleviated after the pressure was increased.The mental and motor function of 2 patients were improved significantly and CT examinations showed decreased ventricles.Conclusious The hydrocephalus associated with congenital intracranial anomalous venous return is rare and the treatment experience is not enough.Pressure - adjustable shunting is the best treatment for this kind of hydrocephalus.The pressure should be adjusted several times for a long time to achieve a suitable individual pressure gradually.