腹腔镜技术在治疗侧脑室-腹腔分流术后分流管腹腔端堵塞中的应用

Application of laparoscopic technique in the treatment of obstruction of the abdominal end of the shunt tube after lateral ventriculoperitoneal shunt

摘要:

目的 探讨腹腔镜技术用于治疗侧脑室-腹腔分流术后分流管堵塞的有效性以及相比传统手术方式的优势。方法 2013年11月到2018年1月，我科利用腹腔镜技术治疗分流管腹腔端堵塞患者8例，回顾和分析这些患者的临床、影像学资料。结果 8例患者术后当日脑积水症状均明显减轻，术后一天复查头颅CT可见脑室系统回缩，间质水肿较术前减轻。8例患者随访三个月以上未见脑积水加重，复查CT脑室系统大小维持稳定。结论 腹腔镜技术用于治疗侧脑室-腹腔分流术后分流管堵塞具有创伤小、视野广、精确度高等特点，能有效避免患者再次行侧脑室-腹腔分流及其他方式手术，减少二次手术创伤，节约治疗费用。

Abstract:

Objective To investigate the effectiveness of laparoscopic technique in the treatment of shunt tube obstruction after lateral ventriculoperitoneal shunt and its advantages over traditional procedure.Methods From November 2013 to January 2018, we used the laparoscopic technique to treat 8 patients with obstruction of the abdominal end of the shunt tube. The clinical and imaging data of these patients were reviewed and analyzed.Results The symptoms of hydrocephalus in the 8 patients were significantly reduced on the day after operation. CT scan one day after the operation showed that the cerebral ventricular system was retracted, and the interstitial edema was lessened. The 8 patients were followed up for more than three months, and no aggravation of hydrocephalus was found. CT re-examination showed that the size of the cerebral ventricular system remained stable.Conclusions The application of laparoscopic technique in the treatment of shunt tube obstruction after lateral ventriculoperitoneal shunt is characterized by small trauma, wide field of vision, and high precision. It can effectively avoid the recurrence of lateral ventriculoperitoneal shunt and other surgical procedures, reduce secondary surgical trauma, and save the cost of treatment.