【摘要】 目的探讨腹腔镜辅助腰大池-腹腔分流术治疗交通性脑积水的应用价值。方法选择交通性脑积水患者60例,随机分为腹腔镜下腰大池-腹腔分流术组(腹腔镜组)和常规开腹手术组(传统手术组),每组各30例。比较两组患者的分流管腹腔端置入时间及置管准确率、术后并发症(分流管堵塞、感染)发生率、远期生活质量评分(Karnofsky评分)。结果腹腔镜组患者的平均腹腔端置入时间[(35±5.5) min]明显短于传统手术组[(20±1.5) min](P <0.001),并发症发生率(感染率3.3%;堵管率0)也明显低于常规手术组(感染率13.3%;堵管率16.7%),分流管腹腔端置管准确率(100%)明显高于对照组(73.3%),差异均有统计学意义(P <0.05～0.001)。术后6个月后随访对患者生活质量进行评分,结果显示腹腔镜组患者的远期生活质量评分明显高于传统手术组,差异有统计学意义(P <0.05)。结论腹腔镜下行腰大池-腹腔分流术不仅手术时间短、置管准确率高;而且术后并发症少,对患者的远期生活质量有良好的改善作用,值得在临床推广应用。更多还原

【Abstract】 Objective To investigate the application value of laparoscopic assisted lumbar cistern peritoneal shunt in the treatment of communicating hydrocephalus. Methods 60 patients with communicating hydrocephalus were randomly divided into laparoscopic lumbar cistern peritoneal shunt group( laparoscopic group) and conventional open operation group( traditional operation group),30 cases in each group. The time and accuracy of abdominal placement of shunt tube,the incidence of postoperative complications( shunt tube blockage,infection) and the longterm quality of life score( Karnofsky score) were compared between the two groups. Result The average time of abdominal end implantation in the laparoscopic group [( 35 ± 5. 5) min] was significantly shorter than that in the traditional operation group [( 20 ± 1. 5) min ]( P < 0. 001),and the incidence of complications( infection rate:3. 3%). The rate of tube plugging( 0%) was significantly lower than that of conventional operation group( 13. 3%).The blocking rate was 16. 7%,and the accuracy rate of abdominal end catheterization of shunt tube( 100%) was significantly higher than that of control group( 73. 3%). The differences were statistically significant( P < 0. 05-0. 001). After 6 months of follow-up,the quality of life of the patients was scored. The results showed that the longterm quality of life score of the laparoscopic group was significantly higher than that of the traditional operation group,and the difference was statistically significant( P < 0. 05). Conclusion Laparoscopic lumbar cistern peritoneal shunt has the advantages of short operation time and high accuracy of catheterization. It is worthy of clinical application.更多还原