脑脊液放液试验对正常压力脑积水患者运动及认知功能的影响

摘要

Objective To explore the effects of cerebrospinal fluid drainage test (CFDT) on motor and cognitive function of patients with normal pressure hydrocephalus (NPH).Methods Motor ability, bladder function and cognitive ability were assessed before and after the CFDT in 86 NPH patients.The patients were assigned to improvement and non-improvement group according to test results and effects of encephalocoele-intraperitoneal drainage (EID) added up.Results At hour 6, 12, 24, 48 and 72 after the CFDT gait scores lowered more significantly, step numbers and times of 10-minute walking test decreased and cognitive function scores improved compared pre-CFDT, all differences were significant (P<0.05 or 0.01), especially at hour 12.Forty-five patients in improvement group underwent the EID and drainage improvement rate was 88.9%, so did 18 ones in non-improvement group and that was 27.8%,and the group difference of drainage improvement rate significant (P<0.01).Conclusion The application of the CFDT in the NPH patients could effectively improve patients' motor ability and cognitive function;hour 12 after the CFDT can be used as the observation point judging the prognosis of the NPH patients undergoing the EID.%目的 探讨脑脊液放液试验对正常压力脑积水患者运动及认知功能的影响.方法 于脑脊液放液试验前后,评定86例正常压力脑积水患者的运动能力、膀胱功能以及认知能力.根据试验结果将患者分为改善组和未改善组,并统计两组患者行脑室-腹腔内引流术的效果. 结果 行脑脊液放液试验后6 h、12 h、24 h、48 h、72 h,本组患者步态评分较试验前显著降低,10 m行走试验步数及时间较试验前显著减少,认知功能评分较试验前有显著改善,差异均有统计学意义(P<0.05或0.01),试验后12 h变化最为明显.改善组行脑室-腹腔内引流术45例,引流改善率为88.9%;未改善组行脑室-腹腔内引流术18例,引流改善率为27.8%;两组引流改善率比较差异有统计学意义(P<0.01).结论 将脑脊液放液试验应用于正常压力脑积水患者,可有效改善患者的运动能力以及认知功能;试验后12 h可以作为正常压力脑积水患者行脑室-腹腔内引流术评判预后的观察点.