目的比较腰大池-腹腔分流术与脑室-腹腔分流术治疗脑积水的临床效果。方法选取18例因脑积水行腰大池-腹腔分流术患者为L-P组,另选择46例因脑积水行脑室-腹腔分流术且一般资料与L-P组均衡的患者为V-P组。比较两组手术时间、术后抗生素使用时间。门诊复查或电话随访3~12个月,记录术后感染、分流管堵塞、癫痫等并发症的发生率。结果L-P组手术时间为(83.11±51.17)min,明显少于V-P组的(121.24±56.62)min,两组比较,差异有统计学意义(P<0.05);L-P组抗生素使用时间为(1.67±1.08)d,明显少于V-P组(4.543±3.07)d,两组比较,差异有统计学意义(P<0.05)。术后随访3~12个月,L-P组术后无感染、无分流管堵塞及癫痫病例;V-P组术后感染率为8.7%(4/46),分流管堵塞率为28.26%(13/46),癫痫发生率为26.08%(12/46)。V-P组并发症发生率明显高于L-P组,差异有统计学意义(P<0.05)。结论与脑室-腹腔分流术相比,腰大池-腹腔分流术治疗脑积水具有手术时间短、抗生素使用时间短的优点,且术后并发症的发生率也较低。
ObjectiveTo compare the clinical efficacy of lumboperitoneal shunt and ventriculoperitoneal shunt in the treatment of hydrocephalus. MethodsEighteen hydrocephalus patients undergoing lumboperitoneal shunt were enrolled as the L-P group and 46 patients underging ventriculopertoneal shunt whose gerneral data correespond with the L-P group were selected as the V-P group. The operation duration, duration of postoperative antibiotics usage were compared between the two groups. The follow-up of 3-12 months was performed by outpatient review or telephone. The incident rates of infection, shunt catheter obstruction and epilepsy after operation were recorded. ResultsThe operation duration of the L-P group was shorter than that of the V-P group [(83.11±51.17)min vs. (121.24±56.62)min, P<0.05]. The duration of postoperative antibiotics usage of the L-P group was shorter than that of the V-P group [(1.67±1.08)d vs. (4.543±3.07)d, P<0.05]. During the follow-up of 3-12 months, no infection, shunt catheter obstruction and epilepsy occurred in the L-P group after operation, but the postoperative incident rates of infection, shunt catheter obstruction and epilepsy were 8.7%(4/46),28.26%(13/46) and 26.08%(12/46), respectively. The incident rate of complications of the V-P group was significantly higher than that of the L-P group(P<0.05). ConclusionCompared to the ventriculoperitoneal shunt, lumboperitoneal shunt has the advantages of shorter operation duration and duration of postoperative antibiotics usage, and has lower incident rate of postoperative complications.