神经内镜治疗梗阻性脑积水疗效分析

发布时间：2018-06-10 00:34

本文选题：梗阻性脑积水 + 脑室腹腔分流术　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]分析神经内镜手术治疗梗阻性脑积水的临床疗效,并评价其临床价值。[方法]回顾性分析2011年12月至2016年12月在昆明医科大学第一附属医院神经外二科共90例梗阻性脑积水患者的临床资料,90例患者中神经内镜手术组47例与脑室腹腔分流手术组(VPS组)43例。根据随访结果比较两组手术时间、住院时间、有效率、KPS评分、术后并发症、死亡率等指标,并进行统计学分析。[结果]1、神经内镜组平均手术时间为(90.09±32.34)分钟,平均住院时间为(20.40±7.91)天;分流组平均手术时间为(117.60±41.74)分钟,平均住院时间(27.33±17.40)天;两组相比,神经内镜组患者的平均手术时间和住院时间较分流组短,并具有统计学意义(P0.05)。2、内镜组手术有效率为100.00%,较分流组手术有效率83.72%高,差异具有统计学意义(P0.05);内镜组平均KPS评分为(97.66±14.63)高于分流组平均KPS评分(63.95±36.98),两组比较差异具有统计学意义(P0.05)。3、两组术后并发症比较,神经内镜组脑室积血、堵管、颅内感染发生率低于分流组,差异具有统计学意义(P0.05)。4、两组死亡率对比,内镜组为2.13%,明显低于分流组为18.60%,差异具有统计学意义(P0.05)。[结论]神经内镜手术治疗梗阻性脑积水,不仅可以解决脑脊液的循环障碍,同时还可处理部分原发病因。内镜手术在提高临床疗效、改善患者远期生活质量,减少术后并发症、降低死亡率等方面优于VPS手术,然而内镜手术并不能完全取代VPS手术。神经内镜手术符合现代神经外科微创、精准的治疗理念。
[Abstract]:Objective: to evaluate the clinical value of endoscopic neurosurgery in the treatment of obstructive hydrocephalus. [methods] the clinical data of 90 patients with obstructive hydrocephalus from December 2011 to December 2016 in Department of external Neurology, first affiliated Hospital of Kunming Medical University were retrospectively analyzed. There were 43 cases in VPS group. The operative time, hospital stay, effective rate and KPS score, postoperative complications and mortality were compared between the two groups according to the results of follow-up. [results] 1. The average operative time and hospital stay were 90.09 卤32.34 and 20.40 卤7.91 days in the endoscopic group and 117.60 卤41.74 minutes and 27.33 卤17.40 days in the shunt group, respectively. The average operative time and hospitalization time of the patients in the endoscopic group were shorter than those in the shunt group, and there was statistically significant difference between the two groups. The effective rate of the endoscopic group was 100.00,83.72%, which was higher than that of the shunt group (83.72%). The average KPS score of endoscopic group was 97.66 卤14.63), which was higher than that of shunt group (63.95 卤36.98). The incidence of intracranial infection was lower than shunt group, the difference was statistically significant (P 0.05). The mortality rate of endoscopic group was 2.13, and that of shunt group was 18.60. The difference was statistically significant (P 0.05). [conclusion] Endoscopic neurosurgery for obstructive hydrocephalus can not only solve cerebrospinal fluid circulatory disorders, but also deal with some primary causes. Endoscopic surgery is superior to VPS in improving clinical efficacy, improving long-term quality of life, reducing postoperative complications and reducing mortality. However, endoscopic surgery can not completely replace VPS surgery. Endoscopic neurosurgery accords with modern neurosurgery minimally invasive and accurate treatment concept.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R651.1

【参考文献】