两期脑室-腹腔分流术治疗急性脑积水和脑室积血的体会

目的 探讨对于脑脊液中含血量较多的急性脑积水、脑室内积血患者,分两期行脑室-腹腔分流术的手术治疗效果.方法 回顾分析10例经侧脑室置管外引流、腰大池置管外引流后脑积水不缓解,且两周后脑脊液中蛋白≥0.5 g/L的患者经先后两期脑室-腹腔分流术（一期金属管芯相连,二期置入分流阀）的手术治疗过程.结果 10例患者中8例患者效果良好,1例腹腔段出现堵管后再次手术,另1例发生术后颅内少量出血,经处理后好转.结论 对于脑脊液内含血较多的慢性脑积水患者,行两期脑室-腹腔分流术治疗,减少堵管及感染的发生,方法简便.

Experience of two stages of ventriculo-peritoneal shunt for treatment of patients with acute hydrocephalus and intraventricular hemorrhage

Objective To investigate the process and the effect of the two phases of ventriculo- peritoneal shunt of patients with various of acute hydrocephalus and intraventricular hemorrhage. Methods A retrospective analysis of 10 patients experienced the two periods of ventriculo- peritoneal shunt （the first phase connect the shunts with metal core and the second use the shunt valve ）, who didn＇ t alleviate after lateral ventricular drainage and lumbar cistern tube drainage, meanwile their CSF still contains protein ≥ 0.5 g/L after two weeks. Results 10 patients were effective in 8 cases, 1 cases of patients operated again with abdominal end blocked, and aother experienced a small amount of postoperative intracranial hemorrhage and the conditions improved after treatment. Conclusion It is a simple method and better treatment effect of the two stages of ventriculo-peritoneal shunt to the patients with acute hydrocephalus whose CSF still contains more blood, and reduces the incidence of infection and pipe blockage.