摘要
目的:腹腔镜技术在神经外科分流手术中的应用价值及临床效果。方法:将72例脑积水及特发性颅内压增高症患者随机分为观察组(n=31)与常规组(n=41),观察组行腹腔镜下分流术,常规组行常规分流手术,对比分析两组疗效及术后分流管梗阻、腹部感染等并发症发生率。结果:两组手术均获成功并取得随访,平均随访(12.0±1.2)个月。术后1周、1个月及3个月行头颅CT及腰椎平片检查。观察组中脑积水患者脑室均缩小至正常,行腹部X线平片检查,引流管均在肝隔面。观察组术后发生堵管2例(6.45%),常规组发生11例(26.83%),两组相比差异有统计学意义(P=0.032)。观察组感染1例(3.23%),常规组感染3例(7.32%);常规组腹部切口愈合不良及分流管脱出3例(7.32%),观察组未发生;两组差异无统计学意义(P>0.05)。结论:腹腔镜下分流术疗效确切,术后分流管堵管率低,患者创伤小,具有较高的安全性,操作简单,值得推广应用。
Objective： To explore the clinical effect of laparoscopy in shunt surgery of neurosurgery department.Methods： Seventy-two patients with hydrocephalus and idiopathic intracranial hypertension were randomly divided into two groups： experimental group（ n= 31） and control group（ n= 41）.Briefly,experimental group was treated with laparoscopic shunt therapy,and conventional shunt operation was performed for the control group.Therapeutic effect and incidence of complications including obstruction of the catheter and abdominal infection were comparatively analyzed,respectively. Results： All patients were performed surgeries successfully and followed up.The postoperative follow-up time was（ 12. 0 ± 1. 2） months and each patient received head CT and lumbar X-ray examination at 1 week,1 month and 3 months after surgery,respectively. The cerebral ventricle of hydrocephalic patients in experimental group was reduced to normal,and the drainage tubes located at the diaphragmatic surface of the liver according to abdominal X-ray examination.Compared with control group（ n = 11,26.83%）,the rate of the catheter obstruction in experimental group（ n = 2,6.45%） was significantly lower（ P = 0.032）.Moreover,the rate of infection in experimental group（ n = 1,3.23%） was similar with that in control group（ n= 3,7.32%）.Additionally,there were 3（ 7. 32%） patients with abdominal incision poor healing and shunt tube removal in control group,and none was found in experimental group,there was no statistically significant difference.Conclusions： Laparoscopic shunt surgery is effective and it is worthy of promotion and application because of lower tube-blocking rate,fewer trauma,safer and simpler operation.
作者
王卫
张家亮
刘浩成
计嘉军
付建柱
康军
WANG Wei;ZHANG Jia-liang;LIU Hao-cheng(Department of Neurosurgery,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)
出处
《腹腔镜外科杂志》
2018年第7期551-553,共3页
Journal of Laparoscopic Surgery
