頁籤選單縮合
題名 | 經皮腰椎腹腔引流之初步報告 |
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作者姓名(中文) | 高振興; 黃俊一; 李良雄; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 21:3 1988.05[民77.05] |
頁次 | 頁334-339 |
分類號 | 416.292 |
關鍵詞 | 經皮腰椎腹腔引流; |
語文 | 中文(Chinese) |
中文摘要 | 榮民總醫院於過去4年間,共有14名患者接受經皮腰椎腹腔引流手術。其中交通性水腦症有6例,開顱傷口膨大者5例,腦脊髓液鼻漏2例,腦脊髓液頭皮瘻管1例。手術後3例發生引液管阻塞,需要修改手術。其中1例經2次修改手術失敗,改用腦室腹腔引流。另外2例,各經1次修改手術後,即恢復通暢。全部患者都經過6-40個月(平均20.9月)之追踪檢查,無器重的併發症。6例交通性水腦症經腰椎腹腔引流手術後,5例獲得明顯進步。1例臨床症狀雖然沒有改善,電腦斷層檢查顯示其腦室已恢復正常的大小。其他4例開顱傷口膨大,2例鼻漏及1例頭皮瘻管的症狀皆痊癒。 腰椎腹腔引流手術的優點為操作簡便,手術時間短,併發症少,不損傷腦組織,無紅吸管現象(siphon phenomenon),然而其最大的限制則為:腦室與腰椎間之蜘蛛膜下腔必須暢通無阻。 |
英文摘要 | In the last four years, a series of 14 patients have undergone a percutaneous lumboperitoneal shunt (PLS) at the Taipei Veterans General Hospital. This series consisted of communication hydrocephalus (6 cases), bulging craniotomy (5 cases), cerebrospinal fluid rhinorrhea (scases) and scalp cutaneous fistula (1 case) . Postoperative shunt obstruction that led to revision of the shunt occurred in three patients. In one of these cases the PLS was replaced by a ventriculoperitoneal shunt after two failures in the revision. In the other two cases, patency was regained after one revision. All the patients have been followed-up for 6 to 40 months (average 20.9 months), and no severe complications have occurred. The clinical symptoms of 5 of the 6 patier.ts with communicating hydrocephalus showed considerable improvement. Although the one remaining case did not show clinical improvement normal ventricular size was shown in the followup CP scan. The 4 cases of bulging craniotomy, 2 cases of CSF rhinorrhea and 1 case of scalp cutaneous fistula all made smooth recoveries. The LPS has the advantages of easy insertion, short operating time, few complications, and absence of brain damage and sighon phenomenon. However, the CSF pathway between the ventricles and spinal subarachnoid space must be patent, and the indications for LPS are accordingly restricted. |
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