老年人特发性正常压力脑积水的临床研究(附35例报道)

摘要

Objective To detect the clinical effect of ventriculo-peritoneal shunt in elderly patients with idiopathic normal pressure hydrocephalus. Methods Thirty-five patients with idiopathic normal pressure hydrocephalus underwent ventriculo-peritoneal shunt and admitted to our hospital from May 2006 and May 2010 were employed in our study; their medical history,CT and MRI scan data,and results of CSF samples obtained by lumbar puncture were retrospectively analyzed; their effects on outcome ofventriculo-peritoneal shunt were analyzed. Results The 6-12 months' follow-up indicated that notable effect was noted in 16 patients, effective result in 12 and ineffective result in 7. The postoperative effective rate in patients with senil intelligence disorder was 58.0％; that in patients with gait instability was 85.0％; and that in patients with urinary incontinence was 81.5％. The imaging examination showed that all the 33 patients had ventricular system shrink to some extent. Conclusion Ventriculo-peritoneal shunt is the most effective method in treating aged patients with idiopathic normal pressure hydrocephalus.%目的 探讨脑室腹腔分流术在老年人特发性正常压力脑积水治疗中的临床疗效.方法 回顾性总结沧州市中心医院神经外科自2006年5月至2010年5月收治的35例老年人特发性正常压力脑积水患者的病史、CT和(或)MR影像资料、腰椎穿刺放液试验等临床资料,分析以上因素对脑室腹腔分流手术效果的影响. 结果 本组35例患者术后均得到6～12月随访,其中显效16例,有效12例,无效7例；智能障碍患者的术后有效率为58.0％,步态不稳患者的术后有效率为85.0％,尿失禁患者的术后有效率为81.5％.33例患者影像学复查见脑室系统均有不同程度缩小. 结论 脑室腹腔分流术是目前治疗老年人特发性正常压力脑积水的最有效方法.