CAJ | 학술논문

目的探讨对于因创伤性脑损伤(traumatic brain injury,TBI)程度过重而无法表现出脑积水症状或表现为非典型症状的创伤后脑积水(post-traumatic hydrocephalus,PTH)患者侧脑室-腹腔(ventricle-peritoneal,V-P)分流术的疗效. 方法对2004年1月-2007年6月经治的接受V-P分流术无典型症状的PTH患者进行回顾性分析.收集患者的一般资料、TBI、PTH和V-P分流术后的随访信息,分析患者预后改善率与相关因素. 结果本组共31例患者,V-P分流术后共随访12个月,其中20例(65％)临床情况有明显改善.10例去骨瓣减压术后合并有PTH患者中,9例在V-P分流术后行颅骨修补术,临床情况明显改善.患者年龄、分流管置入前CT影像评估的PTH严重程度与V-P分流术的效果显著相关. 结论多数无典型症状的PTH患者接受V-P分流术后临床预后改善,并且年轻患者及V-P分流术前PTH严重程度相对较轻的患者在分流术后预后更佳.
목적 탐토대우인창상성뇌손상(traumatic brain injury,TBI)정도과중이무법표현출뇌적수증상혹표현위비전형증상적창상후뇌적수(post-traumatic hydrocephalus,PTH)환자측뇌실-복강(ventricle-peritoneal,V-P)분류술적료효. 방법 대2004년1월-2007년6월경치적접수V-P분류술무전형증상적PTH환자진행회고성분석.수집환자적일반자료、TBI、PTH화V-P분류술후적수방신식,분석환자예후개선솔여상관인소. 결과 본조공31례환자,V-P분류술후공수방12개월,기중20례(65％)림상정황유명현개선.10례거골판감압술후합병유PTH환자중,9례재V-P분류술후행로골수보술,림상정황명현개선.환자년령、분류관치입전CT영상평고적PTH엄중정도여V-P분류술적효과현저상관. 결론 다수무전형증상적PTH환자접수V-P분류술후림상예후개선,병차년경환자급V-P분류술전PTH엄중정도상대교경적환자재분류술후예후경가.
Objective To investigate the effect of ventricle-peritoneal (V-P) shunt in treatment of patients who developed post-traumatic hydrocephalus (PTH) with no symptoms or with atypical symptoms due to an excessively severe traumatic brain injury (TBI).Methods A retrospective study was performed in patients who developed PTH with atypical symptoms undergone V-P shunt from January 2004 to June 2007.Patients' general information,TBI data,PTH severity and postoperative follow-up data were collected and applied to assay the improvement rate in prognosis and its associated factors.Results Thirty-one patients were involved in this study.After 12 months of follow-up,20 (65％) patients revealed significant improvements in clinical symptoms.Among 10 patients who developed PTH after decompressive craniectomy,cranioplasty was performed following V-P shunt and significant improvements were observed in nine patients.Patients' age and severity of PTH based on CT evaluation before shunt placement were strongly correlated with the surgical outcome.Conclusions Most PTH patients with atypical symptoms can benefit from V-P shunt.Additionally,younger patients and those with less severe PTH before V-P shunt are expected a better outcome.