标题：体外可调压微创腰大池-腹腔分流术治疗交通性脑积水13例

      作者：柯尊良，赵浪平，朱鹏博，张国斌，李超，周嘉敏，黄启伟    (九江学院附属医院神经外科，江西 九江 332000)

      卷次： 2018年29卷9期

      【摘要】 目的 分析体外可调压微创腰大池-腹腔分流术治疗交通性脑积水的可行性与优势。方法 回顾性分析2016年6月至2017年5月九江学院附属医院收治的13例重度颅脑损伤和自发性蛛网膜下腔出血导致的交通性脑积水患者的临床资料，所有患者均行体外可调压分流管微创腰大池-腹腔分流术，分析其疗效、并发症及预后，对比其与传统的脑室-腹腔分流术优势。结果 13例患者术后临床症状明显改善，复查CT均提示脑室积水明显减少，无小脑扁桃体下疝表现。2例患者出现双侧减压区塌陷，通过调整压力后好转。术后回归社会正常工作8例，术前5名昏迷患者恢复意识清醒3例，其中1例意识好转，1例术后仍呈昏迷状态。结论 体外可调压微创腰大池-腹腔分流术对交通性脑积水的临床治疗效果显著，操作简单，并发症少，预后佳，对比传统固定阈值的脑室-腹腔分流术和腰大池-腹腔分流术有明显优势。
      【关键词】 体外可调压；腰大池-腹腔分流术；交通性脑积水；脑室-腹腔分流术
      【中图分类号】 R742.7 【文献标识码】 A 【文章编号】 1003—6350（2018）09—1283—02

Communicating hydrocephalus treated by lumbo-peritoneal shunt via variable catheter percutaneous puncturein 13 cases.
KE Zun-liang, ZHAO Lang-ping, ZHU Peng-bo, ZHANG Guo-bing, LI Chao, ZHOU Jia-min, HUANGQi-wei. Department of Neurosurgery, the Affiliated Hospital of Jiujiang University, Jiujiang 332000, Jiangxi, CHINA
【Abstract】 Objective To analyze the feasibility and superiority of lumbo-peritoneal (L-P) shunt via variablecatheter percutaneous puncture in the treatment of communicating hydrocephalus. Methods The clinical data of 13 pa-tients with communicating hydrocephalus caused by severe craniocerebral injury and spontaneous subarachnoid hemor-rhage who were admitted in the Affiliated Hospital of Jiujiang University from June 2016 to May 2017 were analyzed ret-rospectively. All patients underwent L-P shunt via variable catheter percutaneous puncture. The therapeutic effect, compli-cations, and prognosis were analyzed, and compared with those of traditional ventriculoperitoneal shunt. Results Theclinical symptoms of 13 patients were significantly improved after operation. CT examination showed that ventricular hy-drocephalus was decreased significantly, and no subtonsillar hernia was found in all patients. Two cases showed collapsein bilateral decompression zone, which were improved after adjusting the pressure. Eight patients returned to normalwork after operation, and 3 of the 5 coma patients before operation achieved consciousness, with 1 of improved con-scious state and 1 still in coma state. Conclusion L-P shunt via variable catheter percutaneous puncture has significanteffect in the treatment of communicating hydrocephalus, which has advantages of simple operation, less complications,and good prognosis, compared with traditional ventriculoperitoneal shunt.
      【Key words】 Variable catheter; Lumbo-peritoneal shunt; Communicating hydrocephalus; Ventriculoperitonealshunt·临床经验·doi:10.3969/j.issn.1003-6350.2018.09.032基金项目：江西省九江市科技计划项目(编号：2017106)