【作者】 陈真； 华扬； 陈革； 宋为群； 杨远滨； 李广庆； 周景升； 刘霖； 朱琳； 王茂斌；

【Author】 Department of neur-rehabilitation, Department of Ultra-sound, Department of Neuronsurgery, Xuanwu, Hospital, Capital university of medical science, Beijing, 100053

【机构】 首都医科大学附属宣武医院神经康复中心； 首都医科大学附属宣武医院超声科； 首都医科大学附属宣武医院神经外科；

【摘要】 目的探讨早期发现脑损伤患者脑室-腹腔分流管堵塞的诊断方法、主要的康复治疗手段及影响患者预后的因素。方法分析2002年10月～2004年10月脑室-腹腔分流术后2月～2年的30例患者,通过分流管超声、连续CT、MRI,脑室分流管造影三种检查方法来判断脑室分流管的分流情况。对于分流管堵塞的患者实行再通术及术后康复治疗。结果18例诊断为脑室-腹腔分流管堵塞,15例患者进行了再次手术,术后8例患者康复水平较前明显提高,4例呈低反应状态,3例无变化。15例再手术患者手术前和术后半年的GCS评分、FIM评分以及左右脑室直径的比较,差异均有显著性意义(P<0.05)。结论通过分流管超声,动态CT、MRI检查及脑室分流管造影检查并结合临床症状可诊断脑损伤患者的脑室-腹腔分流管分流情况。积极主动的康复治疗可提高患者的康复效果。发现脑室-腹腔分流管堵塞的时间早晚是影响患者预后的重要因素。更多还原

【Abstract】 This article discusses the diagnosis of ventriculoperitoneal shunt obstruction, rehabilitative therapy, and the important factor which effects patients’ prognosis. Method: This is a retrospective review of data for 30 patients who received Ventriculoperitoneal shunt. They were examinated by Doppler ultrasound, continuous CT or/and MRT, and Ventriculoperitoneal shunt radiography. Then according to the patients’ clinical symptoms, we can make a conclusion whether the shunt was obstructed. Those patients whose Ventriculoperitoneal shunt obstructed undergo the operation again. They obtained rehabilitative therapy after operation. Results: There are 18 patients whose Ventriculoperitoneal shunt obstructed, and 15 patients undergo the operation again. There are 8 patients whose rehabilitation outcome improved greatly, and 4 patients became minimal responsive. There is significant difference between the GCS score before treatment and the one after treatment half a year (p<0.05) . The standard Barthel score is the same. Conclusion : Doppler ultrasonic , continuous CT or/and MRT and Ventriculoperitoneal shunt radiography can help us draw the conclusion. Active rehabilitative training can improve the patients’ prognosis. It is very important to find shunt obstruction in the early phase.更多还原