目的 探讨低颅压交通性脑积水治疗方法与临床效果.方法 将有临床表现和经影像学证实的低于正常颅压脑积水患者29例,随机分为可调压组(16例)和固定压组(13例).可调压组采用可调压式分流管进行脑室-腹腔分流术,固定压组固定压式分流管进行脑室-腹腔分流术,对二者进行治疗效果和术后各种并发症发生率分析和比较.结果 两组患者手术后3～6个月全部随访,无死亡和恶化病例.按照Salmon标准评定脑积水分流术疗效:基本恢复正常(3级)；明显好转(2级)；轻度改变(生活自理,1级)；没有无变化(0级)；恶化(-1级)及2个月内手术死亡(-2级).可调压组恢复正常和明显好转14例(87.5％),固定压组恢复正常和明显好转6例(46.15％),两组间比较差异有明显的统计学意义(P＜0.05).可调压组并发症发生1例(6.25％),固定压组并发症发生6例(46.15％),两组间比较差异有明显的统计学意义(P＜0.05).结论 采用可调压式分流管治疗低于正常颅压脑积水会更安全、有效.%Objective We sought the application of regulator ventriculo-peritoneal shunt in patient with low pressure hydrocephalus. Methods 29 patients with low pressure hydrocephalus were randomly divided into a regulator group (16 cases) and fixed- pressure group (13 cases). Regulator group used regulator ventriculo-peritoneal, while fixed pressure group used fixed pressure ventriculo-peritonea. The treatment effect and the incidence of postoperative complications were analyzed and compared. Results All patients were followed up after surgery 3 to 6 months. According Salmon Standard to assess the efficacy on the hydrocephalus, there were 3 cases returned to normal, 2 cases with significant improvement, 1 case with mild change and 2 cases died within 2 months after surgery. The incidence of complications of regulator group (0/16) and fixed pressure group (4/13) were statistically significant (P<0. 05). Conclusion We demonstrate that the application of regulator ventriculo-peritoneal shunt in low pressure hydrocephalus is safer and more effective than fixed pressure ventriculo-peritonea.
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