The Complications Following Ventriculoperitoneal Shunt in Hydrocephalus Patients - Clinical Analysis

水腦症腦室腹腔引流手術之併發症一臨床分析

洪純隆(Shen-Long Howng) ； 林忠男(John-Nan Lin) ； 孫楨民(Jen-Ming Sun)

《The Kaohsiung Journal of Medical Sciences》 1卷7期 (1985/07) Pp. 440-450

https://doi.org/10.6452/KJMS.198507.0440

摘要

自民國70年l月至74年6月四年半中，本院在CT診斷下共經歷174例水腦症病人，其中112位接受腦室腹腔引流手術。本文包括男性69人佔61.6%，女性43人佔38.4%，年齡分佈由2個月到80歲。引起水腦原因有：腦血管疾病31例，佔27.7%，腦瘤29佔25.9%，腦膜炎21例佔18.7%，先天性水腦14例佔12.5%，外傷性水腦8例佔7.1%，正常腦壓性水腦4例佔3.6%，腦膿瘍2例1.8%以及未明原因者3例佔2.7%。112例病人中有38例發生46個併發症，發生率為34%，其中腦室或腹腔導管阻塞24例，術後腦膜炎或腦室炎6例，傷口感染或頭皮壞死3例，接頭脫落3例，腦室細隙現象2例。腹部皮下囊腫2例，腦脊髓液水腫1例，硬腦膜下膿瘍1例，臍痰管1例，腹膜炎l例，腸阻塞1例，腹腔內網膜囊腫l例。我們發現，在引起導管阻塞方面，由Ko-cher's點插入有9例發生率為15.4%（6／39)，而由 Keen's點插入者13例發生率為17.8%(13／73) ，兩者無意義上之差別。

並列摘要

The complications after ventriculoperitoneal (V-P) shunt operations for the treatment of hydrocephalus have occasionally been mentioned. During the past 4½ years, under the diagnosis of computed tomography, we had experienced 174 cases with hydrocephalus and only 112 underwent the V-P shunt procedure. The series comprised 69 males and 43 females with ages ranging from 2 months to 80 years old. The etiology of hydrocephalus included: cerebrovascular disease (31 cases), brain tumor (29 cases), meningitis (21 cases), congenital hydrocephalus (14 cases), traumatic hydrocephalus (8 cases), normal pressure hydrocephalus (4 cases), brain abscess (2 cases) and unknown cause (3 cases).
Post-operatively, 38 patients had developed 46 complications. The incidence of complication was around 34%. It included: ventricular or peritoneal catheter obstruction 24 cases, post-operative meningitis or ventriculitis 6 cases, local wound infection or skin necrosis 3 cases, disconnection of connector 3 cases, slit-ventricle syndrome 2 cases, abdominal subcutaneous cyst 2 cases, CSF edema I case, subdural empyema I case, umbilical fistula I case, peritonitis I case, ileus 1 case and omental cyst I case.
Reviewing our series, there was no significant difference in the incidence of obstruction using either Kocher’s (6/39, 15.4%) or Keen’s (13/73, 17.8%) approach.

並列關鍵字

ventriculoperitoneal shunt ； slit-ventricle syndrome ； cerebrospinal fluid edema