脑积水脑室-腹腔分流术后常见并发症及防治对策

目的：探讨脑积水脑室-腹腔分流术后常见并发症的原因及防治措施。方法回顾性分析2008-04～2013-01收治的脑积水脑室-腹腔分流术后并发症患者19例临床资料。结果19例中分流管阻塞7例，感染4例，硬膜下血肿或积液4例，分流管异位2例，分流管自肛门脱出1例，经治疗后患者临床症状不同程度缓解，13例患者再次行脑室-腹腔分流术，16例进行性脑积水患者复查头颅CT或MRI提示脑积水明显好转。19例患者中治愈18例，1例死于严重颅内感染，近期有效率为94.7％。结论临床应严格脑积水脑室-腹腔分流术适应证选择及无菌操作，提高手术技巧，个体化选择分流系统，对年幼患者应用可调压分流管，可减少术后并发症的发生。

Complications after ventriculo-peritoneal shunt in the patients with hydrocephalus and the corresponding measures of prevention and treatment

Objective To explore the reasons of common complications after ventriculo-peritoneal shunt in the patients with hydrocephalus and the corresponding measures of prevention and treatment .Methods A retrospec-tive analysis was performed on the clinical data of 19 patients with hydrocephalus who had postoperative complications of ventriculo-peritoneal shunt from April 2008 to January 2013.Results In the 19 patients, obstruction of shunt tube appeared in 7 cases, infection in 4 cases, subdural hematoma or dydrops in 4 cases, ectopia of shunt tube in 2 cases and prolapse shunt tube from anus in 1 case.After treatment, patients′clinical manifestation relieved in different de-gree.Ventriculo-peritoneal shunt was performed again in 13 patients.The reviews of head CT or MRI on 16 patients with progressive hydrocephalus showed marked improvement of hydrocephalus .In 19 cases, 18 cases were cured, 1 case died of serious intracranial infection .The effective rate was 94.7%.Conclusion Strictly mastering indications and aseptic technique of ventriculo-peritoneal shunt for hydrocephalus , improving the operation skills , selecting shunt system individually and adopting adjustable valve shunts to young patients , can reduce the occurrence of postoperative complications .