CAJ | 학술논문

目的探讨腰大池-腹腔分流术(LPS)治疗交通性脑积水的临床疗效.方法回顾性分析2009年9月至2013年12月因交通性脑积水在我院行腰大池-腹腔分流术的患者,术前均行腰大池置管脑脊液外引流,患者均有不同程度的昏迷,观察分流术后意识状态的变化及并发症情况.结果本组共12例,7例行常规腰池腹腔分流术,5例采用了可调压式分流阀门.3例意识转清,8例意识好转,颅骨减压窗张力均下降,复查头颅CT脑室均有缩小,1例分流管脱入腹腔;无感染、颅内出血、分流管堵塞、癫痫等病例.结论对于无脊柱及腹部手术禁忌症的交通性脑积水患者,LPS可以做为优先选择,术前的腰大池置管脑脊液外引流有助于预测LPS的手术效果.
목적 탐토요대지-복강분류술(LPS)치료교통성뇌적수적림상료효.방법 회고성분석2009년9월지2013년12월인교통성뇌적수재아원행요대지-복강분류술적환자,술전균행요대지치관뇌척액외인류,환자균유불동정도적혼미,관찰분류술후의식상태적변화급병발증정황.결과 본조공12례,7례행상규요지복강분류술,5례채용료가조압식분류벌문.3례의식전청,8례의식호전,로골감압창장력균하강,복사두로CT뇌실균유축소,1례분류관탈입복강;무감염、로내출혈、분류관도새、전간등병례.결론 대우무척주급복부수술금기증적교통성뇌적수환자,LPS가이주위우선선택,술전적요대지치관뇌척액외인류유조우예측LPS적수술효과.
Objective To assess the clinical effect of lumboperitoneal shunting (LPS) on communicating hydrocephalus.Methods An retrospectively study was conducted on communicating hydrocephalus patients who were hospitalized from Sep.2009 and Dec.2013 at the No.174th Hospital of Chinese People's Liberation Army.All patients were underwent the LPS.All patients were with difference degrees of coma,and lumbar punctured for continued cerebrospinal fluid extended drainage before LPS.The change of disturbance of consciousness and the complications of LPS were assessed.Results There were 12 patients with communicating hydrocephalus.Of them,7 cases were underwent routine lumboperitoneal shunts,and 5 cases were experienced adjustment valve.After the LPS operation,3 patients were awakened from the coma,and 8 patients were improved in terms of consciousness and the decompression pressure of skull window as well as decreased enlarged lateral ventricles in pre-operation by CT.As for another 1 patient,the lumboperitoneal catheter had been slipped into the peritoneal cavity after 2 months of operation.There were no complications of infection,intracranial hemorrhages,obstruction of catheter and epilepsy.Conclusion The LPS should be the first selection of those patients who suffered from communicating hydrocephalus without trouble in spine and abdomen.A positive response to pre-operative continuing cerebrospinal fluid extend drainage is good prediction factor for surgical results of LPS.