| 摘要: |
| ［摘要］ 目的 观察脑室-腹腔长程外引流术治疗术后颅内感染并发急性脑积水的效果。方法 回顾性分析2022年1月至2025年6月湖南省第二人民医院（湖南省脑科医院）收治的80例因急性脑损伤手术后发生颅内感染并发急性脑积水患者的临床资料，其中采用脑室-腹腔长程外引流术治疗者32例（观察组），采用常规侧脑室额角置管外引流术治疗者48例（对照组）。比较两组围手术期指标及预后指标。结果 观察组单次手术引流时间、单次手术时间长于对照组，手术总次数少于对照组，二次颅内感染、脑脊液切口漏以及导管移位发生率低于对照组，差异有统计学意义（P<0.05）。两组术后3个月时脑积水改善率、改良Rankin量表（mRS）评分、脑室-腹腔分流术（VPS）治疗率以及死亡率比较差异无统计学意义（P>0.05）。结论 对于需等待颅内感染完全控制而长期留置引流管的梗阻性脑积水患者，脑室-腹腔长程外引流术可延长引流时间，减少手术次数，降低二次颅内感染、脑脊液切口漏及导管移位等并发症发生率，是一种有效的补充治疗路径。 |
| 关键词: 脑室外引流术 长程外引流 颅内感染 脑积水 预后 |
| DOI：10.3969/j.issn.1674-3806.2026.07.07 |
| 分类号: |
| 基金项目:湖南创新型省份建设专项（编号：2025JJ90104） |
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| Observation on the efficacy of ventriculoperitoneal long-tunneled external drainage for postoperative intracranial infection complicated with acute hydrocephalus |
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Chen Jiru1, Du Hao1, Li Xin2
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1.School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha 410208, China; 2.Department of Neurosurgery, the Second People′s Hospital of Hunan Province(Brain Hospital of Hunan Province), Changsha 410021, China
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| Abstract: |
| ［Abstract］ Objective To observe the efficacy of ventriculoperitoneal long-tunneled external drainage in treatment of postoperative intracranial infection complicated with acute hydrocephalus. Methods A retrospective analysis was conducted on the clinical data of 80 patients with postoperative intracranial infection complicated with acute hydrocephalus following surgery for acute brain injury who were admitted to the Second People＇s Hospital of Hunan Province(Brain Hospital of Hunan Province) from January 2022 to June 2025. Among the 80 patients, 32 patients were treated with ventriculoperitoneal long-tunneled external drainage(observation group), and the other 48 patients were treated with conventional external ventricular drainage via frontal horn puncture(control group). Perioperative indicators and prognostic indicators were compared between the two groups. Results The single drainage duration and single operation duration in the observation group were longer than those in the control group. The total number of operations in the observation group was less than that in the control group. The incidence rates of secondary intracranial infection, cerebrospinal fluid leakage at the incision and catheter displacement in the observation group were lower than those in the control group.The above differences were statistically significant between the two groups(P<0.05). There were no statistically significant differences between the two groups in the improvement rate of hydrocephalus, modified Rankin Scale(mRS) scores, the treatment rate of ventriculoperitoneal shunt(VPS) and mortality rate at 3 months postoperatively(P>0.05). Conclusion For patients with obstructive hydrocephalus who require long-term drainage catheter indwelling while awaiting complete control of intracranial infection, ventriculoperitoneal long-tunneled external drainage can prolong drainage duration, reduce the number of operations, reduce the incidence rates of secondary intracranial infection, cerebrospinal fluid leakage at the incision and catheter displacement, and therefore is an effective supplementary treatment approach. |
| Key words: external ventricular drainage(EVD) long-tunneled external drainage intracranial infection hydrocephalus prognosis |
