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目的探讨脑室-腹腔分流术治疗结核性脑膜炎并发重度脑积水的效果。方法对15例结核性脑膜炎并发重度脑积水的患者进行脑室-腹腔分流术治疗,观察其疗效。结果15例患者中,10例术后颅内压增高症状很快缓解,未发生并发症;5例术后出现分流管阻塞,其中1例死亡。分流管阻塞患者与未阻塞患者脑脊液蛋白含量及细胞数有明显差异(P<0.01或P<0.05)。结论脑室-腹腔分流术可以作为治疗结核性脑膜炎并发重度脑积水的手段,是否先行脑室外引流术可根据脑脊液蛋白含量及细胞数而定。
Objective To investigate the effect of intraventricular-peritoneal shunt on patients with tuberculous meningitis complicated with severe hydrocephalus. Methods Fifteen patients with tuberculous meningitis complicated with severe hydrocephalus were treated with ventricular-peritoneal shunt and the curative effect was observed. Results Of the 15 patients, 10 patients had rapid relief of intracranial pressure and no complications occurred. Five patients had obstruction of the shunt after operation, of which 1 died. There was a significant difference (P <0.01 or P <0.05) in CSF protein content and cell number in patients with obstructed shunt and non-obstructed patients. Conclusion Ventricular-peritoneal shunt can be used as a means of treating severe hydrocephalus complicated with tuberculous meningitis. Whether or not preemptive intraventricular drainage can be determined according to cerebrospinal fluid protein content and cell number.