脑室-腹腔分流术后常见并发症及其治疗体会

目的 探讨脑室-腹腔分流术后常见并发症的发生原因、临床表现特点及治疗方法,结合文献讨论对其术后并发症的防治措施。方法1994年3月～1999年3月共施行脑室-腹腔分流手术34例,术后井发症予以对症治疗。结果 术后8例发生并发症,分流管梗阻者5例,感染者3例。5例分流管梗阻者,经手术调整分流管位置(例)或分流泵穿刺冲洗(1例)等处理治愈。3例术后发生感染者经抗感染药物治疗,1例治愈;2例无效而拔管,在感染控制后行二次分流术治愈。结论 脑室-腹腔分流手术后的并发症与手术无菌操作不严格和分流管位置不当有关。治疗方法以对症处理为原则,分流管梗阻者可经调整分流管位置使之通畅;颅内或腹腔感染予以抗感染治疗或感染控制后行二次分流术;皮下积血或积液应以静脉留置针管进行引流。

Common complications in ventriculoperitoneal shunt and its treatment

Objective To study the pathogenesis, clinical characteristics and treatment of common-complications in ventriculoperitoneal shunt (VPS). The related literatures were reviewed and the preventive measures for complicatios of VPS were discussed. Methods The VPS was performed in 34 patients during March in 1994-March in 1999. Postoperative complications were treated expectantly. Results Postoperative complications were found in 8 cases: obstruction of shunt tube in 5 cases and infection in 3 cases. Of the 5 cases with shunt tubes obstruction, shunt tubes in 4 cases were adjusted and 1 case was washed by puncturing the shunt reservoir. All the 5 cases recovered. The 3 cases with infection were treated with anti-infective therapy, one of them recovered, while the other two cases were cured by second shunt operation after extracting the shunt tubes. Conclusion The postoperative complications of VPS are associated with not following the strict aseptic manipulation and inappropriate setting of VPS tubes. The treating measures are based on the expectant treatment rules, eg adjusting the VPS tube to get rid of obstruction, anti-infection in intracranial or peritoneal infection, and drainage of subcutaneous hematocele or hydrops with intravenous indwelling needle.