可调压腰大池腹腔分流手术治疗特发性颅内压增高的临床效果

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摘要目的探讨可调压腰大池腹腔分流手术治疗特发性颅内压增高（IIH）的临床效果。方法回顾性分析2010年1月～2016年1月首都医科大学附属北京同仁医院神经外科收治的37例IIH致视功能损害患者的临床资料。所有患者均行可调压腰大池腹腔分流手术。观察患者手术前后的颅内压，临床症状改善情况和术后并发症情况。结果 37例患者中，术后颅内压力均降低至250 mmH2O以下；总71侧患眼视力改善41眼，其中视力≥0.1组改善23眼，视力＜0.1组改善18眼；30例视乳头水肿患者中术后改善24例；22例头痛患者中有19例明显改善；37例患者中，分流管阻塞2例，所有患者无感染发生。结论可调压腰大池腹腔分流手术对于治疗IIH所致的头痛、视乳头水肿，改善视力下降和/或视野缺损，安全、有效，短期疗效良好。对于视力明显下降患者应尽可能在视力≥0.1时积极治疗。

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	董浩李永徐勇赵景武宋贵东康军▲

关键词 ：特发性颅内压增高, 视力, 视野, 视乳头水肿, 腰大池腹腔分流手术

Abstract：Objective To investigate the clinical effect of adjustable lumboperitoneal shunt in the treatment of idiopathic intracranial hypertension (IIH). Methods The clinical data of 37 patients with visual impairment caused by IIH admitted to the Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University from January 2010 to January 2016 were retrospectively analyzed. All patients underwent adjustable lumboperitoneal shunt. Intracranial pressure, improvement of clinical symptoms before and after operation and postoperative complications were observed. Results In 37 patients, intracranial pressure decreased to below 250 mmH2O after operation. In a total of 71 sides of affected eye, the visual acuity improved on 41 eyes, including 23 eyes in the group with visual acuity ≥0.1 and 18 eyes in the group visual acuity ＜0.1. Among the 30 patients with papilledema, 24 had improved after operation. There was a significant improvement in 19 cases of the 22 patients with headache. Among the 37 patients, 2 cases had shunt obstruction and no infection occurred in all patients. Conclusion It is safe, effective and has a good short-term effect for adjustable lumboperitoneal shunt in the treatment of IIH-induced headache and papilledema, as well as the improvement of visual acuity loss and/or visual field defects. For patients with significant visual acuity loss, active treatment should be performed as soon as possible when visual loss is ≥0.1.

Key words： Idiopathic intracranial hypertension Visual acuity Visual field Papilledema Lumboperitoneal shunt

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引用本文:

董浩李永徐勇赵景武宋贵东康军▲. 可调压腰大池腹腔分流手术治疗特发性颅内压增高的临床效果[J]. 中国医药导报, 2020, 17(20): 93-96,110.
DONG Hao LI Yong XU Yong ZHAO Jingwu SONG Guidong KANG Jun▲. Clinical effect of adjustable lumboperitoneal shunt in the treatment of idiopathic intracranial hypertension. 中国医药导报, 2020, 17(20): 93-96,110.

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