低于正常颅压交通性脑积水的治疗探讨

目的探讨低颅压交通性脑积水治疗方法与临床效果。方法将有临床表现和经影像学证实的低于正常颅压脑积水患者29例,随机分为可调压组（16例）和固定压组（13例）。可调压组采用可调压式分流管进行脑室-腹腔分流术,固定压组固定压式分流管进行脑室-腹腔分流术,对二者进行治疗效果和术后各种并发症发生率分析和比较。结果两组患者手术后3～6个月全部随访,无死亡和恶化病例。按照Salmon标准评定脑积水分流术疗效：基本恢复正常（3级）;明显好转（2级）;轻度改变（生活自理,1级）;没有无变化（0级）;恶化（-1级）及2个月内手术死亡（-2级）。可调压组恢复正常和明显好转14例（87.5%）,固定压组恢复正常和明显好转6例（46.15%）,两组间比较差异有明显的统计学意义（P〈0.05）。可调压组并发症发生1例（6.25%）,固定压组并发症发生6例（46.15%）,两组间比较差异有明显的统计学意义（P〈0.05）。结论采用可调压式分流管治疗低于正常颅压脑积水会更安全、有效。

Exploring of treatment of low pressure hydrocephalus

Objective We sought the application of regulator ventriculo-peritoneal shunt in patient with low pressure hydrocephalus.Methods 29 patients with low pressure hydrocephalus were randomly divided into a regulator group（16 cases） and fixed-pressure group（13 cases）.Regulator group used regulator ventriculo-peritoneal,while fixed pressure group used fixed pressure ventriculo-peritonea.The treatment effect and the incidence of postoperative complications were analyzed and compared.Results All patients were followed up after surgery 3 to 6 months.According Salmon Standard to assess the efficacy on the hydrocephalus,there were 3 cases returned to normal,2 cases with significant improvement,1 case with mild change and 2 cases died within 2 months after surgery.The incidence of complications of regulator group（0/16） and fixed pressure group（4/13） were statistically significant（P〈0.05）.Conclusion We demonstrate that the application of regulator ventriculo-peritoneal shunt in low pressure hydrocephalus is safer and more effective than fixed pressure ventriculo-peritonea.