Application of peritoneal catheter via pneumoperitoneum puncturation in cerebral spinal fluid peritoneal shunt surgery
10.3969/j.issn.1008-9691.2018.01.005
- VernacularTitle:腹腔穿刺微创置管术在脑积水腹腔分流术中的应用
- Author:
Yihai LIN
1
;
Fei CHEN
;
Xin JIN
;
Junhua HE
;
Jun KONG
;
Zhangyi WU
;
Hai YU
Author Information
1. 浙江省立同德医院神经外科
- Keywords:
Hydrocephalus;
Peritoneal shunt;
Pneumoperitoneum;
Complications
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2018;25(1):20-23
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the application value of the peritoneal catheter via pneumoperitoneum puncturation in cerebral spinal fluid (CSF) peritoneal shunt surgery. Methods The clinical data of 490 hydrocephalus patients admitted to Zhejiang Provincial Tongde Hospital from June 2002 to December 2016 were retrospectively analyzed, among them 147 cases accepted ventriculoperitoneal shunt (VPS) operation from June 2002 to January 2009 were assigned as a control group (open abdomenal catheterization group), and 343 cases accepted pneumoperitoneum puncturation from February 2009 to December 2016 were arranged as an observation group (abdominal paracentesis group). The patients in the abdominal paracentesis group were further subdivided into a VPS group (228 cases) and a lumboperitoneal shunt (LPS) group (115 group) according to different ways of catheterization. The clinical data such as infection, shunt obstruction (blockage), bleeding and other complications (such as insufficient or excessive drainage, bleeding, epilepsy, intestinal obstruction) 6 mouths after operation were collected in open catheterization group and abdominal paracentesis group, the difference of incidences of complication in each group were compared. Results The incidences of infection [10.20% (15/147) vs. 3.79% (13/343)], shunt obstruction [14.29% (21/147) vs. 7.58% (26/343)], other complications [23.13% (34/147) vs. 10.79% (37/343)] in open catheterization group were significantly higher than those in abdominal paracentesis group (all P < 0.05); the rate of shunt obstruction in VPS group was higher than that in LPS group [9.65% (22/228) vs. 3.48% (4/115), P < 0.05]. Conclusions Pneumoperitoneum puncturation is a simple, safe, minimally invasive technique to implant an abdominal cavity shunt catheter in CSF peritoneal shunt surgery, and it can effectively reduce the rates of infection and shunt blockage; LPS is more effective than VPS in reducing the incidence of the blockage by this paracentesis method.
