[1]郭文龙,李嵌嵌,詹升全,等.脑室心房分流在脑室腹腔分流难治的脑积水中的临床应用[J].临床神经外科杂志,2014,(04):295-297.
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脑室心房分流在脑室腹腔分流难治的脑积水中的临床应用()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
期数:
2014年04期
页码:
295-297
栏目:
论著
出版日期:
2014-08-31

文章信息/Info

Title:
The Ventriculoatrial Shunt in the treatment of refractory Hydrocephalus
作者:
郭文龙 李嵌嵌 詹升全 王鹏 周德祥 周东
广东省人民医院
关键词:
脑积水 脑室心房分流 脑室腹腔分流
Keywords:
Hydrocephalus Ventriculoatrial Shunt Ventriculoperitoneal Shunt
分类号:
R651.1
文献标志码:
A
摘要:
目的 回顾分析难治性脑积水患者反复脑室腹腔分流(Ventriculoperitoneal shunt,VP)失败后改脑室心房分流(Ventriculoatrial shunt,VA)的临床治疗情况。方法 收集2000年至2012年间我院收治的反复VP失败后改行VA手术的脑积水患者,回顾分析其治疗情况和预后;同时利用logistic回归分析年龄、性别、术前是否感染、术前手术次数、以及术侧与VA手术的成败是否相关。结果 共入选46例患者,其中首次VA成功的占73.9%(34/46),首次失败的占26.1%(12/46),原因包括感染、静脉血栓、分流管心房端移位等。logestic回归分析显示年龄、性别、术前是否感染、术前手术次数、术侧与首次VA手术的成败不相关。首次失败后的有12例患者,经过重新手术后成功的58.3%(7/12);经再手术仍然失败并且最终死亡的占41.7(5/12),原因为感染和肺动脉高压。结论 VA治疗反复VP失败的脑积水患者仍然具有较高的成功率;但首次VA失败后,再失败的机率高,结果严重。
Abstract:
Objective Retrospectively analyzed the clinical outcome of VA shunt converted from multiple failure of VP shunt for the refractory hydrocephalus patients.Methods Retrospectively analyze the treatment and outcome of the VA shunt patients after multiple failure of VA shunt from 2000 to 2012. And the datas were also collected and analyzed to see whether age, gender, infection, times of previous operation, operative side are any associated with the outcome of the VA shunt operation. Results There were 46 eligible patients, among which 73.9%(34/46) succeeded and 26.1%(12/46) failed after the first time of VA shunt for these group of patients. Reasons for the failure included infection, venous embolization, displaced distal catheter and so on so forth. Outcomes of the operation were not related to any of the factors including age, gender, infection, times of previous operation, operative side. 12 patients failed after the first VA Shunt. Future Success were achieved in 58.3%(7/12) of them. 41.7%(5/12) of the patients died:4 were because of sever infection and 1 was because of pulmonary artery hypertension. Conclusion VA is efficient for the refractory hydrocephalus patient after multiple failure of VA shunt; but the rate of failure is high after the failure of first VA shunt and the result could be devastating.

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备注/Memo

备注/Memo:
[收稿日期] 2014-03-06
更新日期/Last Update: 2014-08-15