眼科

• 论著 • 上一篇    下一篇

腰大池-腹腔分流术治疗特发性颅内压增高症的效果

赵尚峰1  张家亮1  李永1  吴江平1  刘浩成1  孙思1  王卫1  马建民2   王佳伟3  康军1   

  1. 1首都医科大学附属北京同仁医院神经外科100730;2首都医科大学附属北京同仁医院眼科 100730;3首都医科大学附属北京同仁医院神经内科 100730
  • 收稿日期:2020-03-23 出版日期:2020-07-22 发布日期:2020-07-21
  • 通讯作者: 康军,Email:junkang2015@163.com

Efficacy of lumboperitoneal shunt for idiopathic intracranial hypertension

Zhao Shangfeng1, Zhang Jialiang1, Li Yong1, Wu Jiangping1, Liu Haocheng1, Sun Si1, Wang Wei1, Ma Jianmin2, Wang Jiawei3, Kang Jun1   

  1. 1 Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; 2 Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; 3 Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
  • Received:2020-03-23 Online:2020-07-22 Published:2020-07-21
  • Contact: Kang Jun, Email: junkang2015@163.com

摘要:  目的 观察腰大池-腹腔分流术(lumboperitoneal shunt,LPS)治疗特发性颅内压增高症(idiopathic intracranial hypertension,IIH)的有效性和安全性。设计 回顾性病例系列。研究对象 北京同仁医院IIH行LPS手术的患者114例。方法 回顾患者LPS术前、术后的病历资料。平均随访(3.4±1.2)个月(2~16个月)。主要指标 最佳矫正视力(BCVA)、视野、视乳头水肿程度、头痛程度以及术后并发症。结果 术前BCVA<0.05者62例(59.6%),术后3个月30例(28.8%)(P=0.000)。视野缺损术后改善66例(70.2%)。术前视乳头轻度水肿58例(50.9%),重度水肿25例(21.9%);术后3个月视乳头轻度水肿54例(47.4%),重度水肿7例(6.1%)。头痛术后3个月缓解67例(93.1%)。术后分流管阻塞3例,感染2例。随访期间分流管调整12例,平均调整1.4次。结论 短期随访结果显示,LPS术能有效改善IIH患者的视力、视野、头痛症状和视乳头水肿程度。(眼科, 2020,29: 255-259)

关键词: 特发性颅内压增高症, 腰大池-腹腔分流术

Abstract:  Objective To evaluate the efficacy and safty of lumboperitoneal shunt (LPS) for treatment of idiopathic intracranial hypertension (IIH). Design Retrospective case series. Participant 114 IIH patients with LPS from Beijing Tongren Hospital. Methods The medical records of patients before and after LPS surgery were reviewed. The patients were followed up for 3.4±1.2 (2-16) months. Main Outcome Measures Best corrected visual acuity (BCVA), visual field, papilledema, headache and complications. Results 62 cases (59.6%) with preoperative BCVA<0.05 reduced to 30 cases(28,8%) after LPS (P<0.05). 66 cases(70.2%) of visual field defect were improved. Mild papilledema occurred in 58 cases(50.9%) before LPS, and severe papilledema in 54 cases(47.4%), while 25 cases(21.9%) remained with mild papilledema, and 7 cases(6.1%) with severe papilledema after LPS. Headache in 67 cases (93.1%) alleviated 3 months after LPS. During the follow-up period, shunt obstruction developed in 3 cases and shunt infection in 2 cases postoperatively. 12 cases underwent shunt adjustments, with an average of 1.4 times. Conclusion The short-term follow-up in this study showed that LPS can effectively relieve the visual acuity, visual field, headache and papilledema caused by IIH. (Ophthalmol CHN, 2020, 29: 255-259)

Key words: idiopathic intracranial hypertension, lumboperitoneal shunt