摘要目的 探讨脑室-腹腔分流术常见并发症原因.方法 回顾性分析首都医科大学附属北京天坛医院神经外科2003年6月至2009年9月收治的430例行脑室-腹腔分流术患者的临床资料,对并发症进行分析.结果 术后出现并发症104例(24.2％):分流管梗阻48例,感染25例,硬膜下血肿或积液23例,癫痫4例,脑室出血4例.比较可调压分流管组与固定压力管组,硬膜下血肿或积液发生率差异有统计学意义(P =0.032),≤14岁与＞14岁两组比较硬膜下血肿或积液发生率差异有统计学意义(P =0.016).结论 合理选择分流管类型,注意术中的无菌操作和手术技巧,对减少并发症的发生非常重要.可调压分流管较固定压力管在预防过度分流方面更具有优势.年龄小的患儿选择分流管时应更加慎重.

abstractsObjective To investigate the causes for common complications in ventriculoperitoneal shunt.Method The clinical data of 430 patients that underwent ventriculoperitoneal shunt were analyzed retrospectively from June 2003 to September 2009.Results Postoperative complications found in 104 cases (24.2％) included shunt blockage (48 cases),infection (25 cases),subdural hematoma or effusion (23 cases),epilepsy (4 cases),and intraventricular hemorrhage (4 cases).There were significant differences (P =0.032) with the occurrence rates of subdural hematoma or effusion between the programmable valve shunt groups and the nonprogrammable shunt groups.According to the standard age of 14 years old,the patients were divided into two groups and the occurrence rates of subdural hematoma or effusion had significant differences (P =0.016).Conclusions Choosing the optimum shunt system,delicate operation and minimal postoperative complications may play an important role in improving the outcome of shunting surgery for patients with hydrocephalus.Programmable shunt is better than nonprogrammable shunt in preventing excessive shunt of VPS.In addition,we should pay more attention to select the optimum shunt for children.