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find Keyword "脑室腹腔分流" 6 results
  • Effectiveness of Programmable Valves for Hydrocephalus: A Systematic Review

    Objective To systematically review the clinical effectiveness and safety of programmable valves (PV) vs. standard valves (SV) for hydrocephalus. Methods Literature search was conducted in PubMed, The Cochrane Library, EMbase, CNKI, CBM, VIP and WanFang Data to collect both randomized controlled trials (RCTs) and non-randomized concurrent controlled trials on hydrocephalus treated by PV and SV published from January 1992 to January 2012. According to the inclusion criteria, two reviewers independently screened articles, extracted data, and evaluated and cross-checked the quality of the included studies. Then meta-analysis was performed using RevMan 5.0 software. Results A total of 11 non-randomized concurrent controlled trials involving 1,485 participants were included. The results of meta-analysis showed that, compared with SV, PV was superior in overall effective rate (RR=1.14, 95%CI 1.03 to 1.27, P=0.01), 2-year survival rate (RR=1.25, 95%CI 1.04 to 1.51, P=0.02), secondary surgery rate (RR=0.53, 95%CI 0.39 to 0.73, Plt;0.001), overall complications rate (RR=0.62, 95%CI 0.51 to 0.76, Plt;0.001), and over-drainage/ under-drainage rates (RR=0.42, 95%CI 0.21 to 0.83, P=0.01). But there were no significant differences in 1-year survival rate (RR=1.04, 95%CI 0.91 to 1.19, P=0.55), postoperative infection rate (RR=1.08, 95%CI 0.73 to 1.60, P=0.71) and valve related complication rate (RR=0.80, 95%CI 0.56 to 1.21, P=0.20) between the two groups. Conclusion Current evidence suggests that PV is superior to SV in increasing the effective rate, decreasing complications, and prolonging the long-term survival rate. Because of the limitation of quantity and quality of the included studies, more high quality, multicenter and double-blind RCTs are needed to prove whether PV can be clinically recommended as a preferred drainage surgery or not.

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  • Endoscopic Third Ventriculostomy versus Ventriculal Peritoneum Shunt Surgery for Hydrocephalus: A Systematic Review

    Objective To evaluate the clinical effectiveness of endoscopic third ventriculostomy (ETV) and ventriculal peritoneum shunt (VPS) for hydrocephalus. Methods A fully recursive literature search was conducted in PubMed (1996 to June, 2011), EMBASE (1996 to June, 2011), Cochrane Central Register of Controlled Trials (Issue 3, 2011), CBM (1996 to June, 2011), CNKI and Wanfang Database (1996 to June, 2011) in any language. The randomized or non-randomized controlled trials of hydrocephalus treated by endoscopic third ventriculostomy and ventriculal peritoneum shunt were considered for inclusion. The analyzed outcome variables were overall complications and the survival rate of all time points. Data related to clinical outcomes were extracted by two reviewers independently. Statistical analyses were carried out by using RevMan 5.0 software. Results Nine published reports of eligible studies involving 1 187 participants met the inclusion criteria. Compared with VPS, ETV had no significant differences in short-term (1 or 2 years) survival rate (RR=1.02, 95%CI 0.90 to 1.16, P=0.74; RR=1.14, 95%CI 1.00 to 1.30, P=0.06), but there were significant differences between the two groups in overall complication rate (RR=0.70, 95%CI 0.57 to 0.89, P=0.001), postoperative 3-year survival rate (RR=1.23, 95%CI 1.07 to 1.41, P=0.004), and postoperative 5-year survival rate (RR=1.14, 95%CI 1.29 to 1.66, P=0.05). So the outcomes indicated ETV was superior in controlling the overall complication rate and prolonging the long-term survival rate. Conclusion Current evidence suggests that endoscopic third ventriculostomy is superior to ventriculal peritoneum shunt in reducing the overall complications and prolonging the long-term survival rate, but there is no significant difference in short-term survival rate between the two methods. The effectiveness of the two operational methods for hydrocephalus caused by all specific reasons still has to be further proved by more high-quality, multi-centered and double-blind RCTs.

    Release date:2016-08-25 02:39 Export PDF Favorites Scan
  • 早期颅骨修补和脑室腹腔分流术治疗脑外伤的疗效分析

    摘要:目的:探讨早期颅骨修补和脑室腹腔分流术治疗脑外伤的疗效。方法: 将58例颅骨缺损并脑积水患者分为对照组和治疗组。对照组行早期去骨瓣减压术,治疗组行早期颅骨修补和脑室腹腔分流术,评价两组的疗效。结果: 对照组行早期去骨瓣减压术后,有11例(55%)患者神经功能障碍有不同程度的改善,按照GCS表进行预后判断,恢复良好7例(35%),中残8例(40%),重残2例(10%),植物生存2例(10%),死亡2例;术后治疗组患者均在1~3月内行早期颅骨修补并脑室腹腔分流术,术后未出现并发分流管堵塞,并发颅内感染2例;有33例(88%)患者意识及神经功能障碍不同程度改善;按照GCS表进行预后判断,恢复良好20例(56.6%),中残9例(23.7%),重残8例(21.1%),植物生存1例(2.6%),未出现手术死亡病例。结论: 早期颅骨修补和脑室腹腔分流术可恢复脑的生理结构,明显缓解患者意识及神经功能障碍。

    Release date:2016-08-26 03:57 Export PDF Favorites Scan
  • Experience of Laparoscopic Ventriculo-Peritoneal Shunt

    Objective To summarize the experience of laparoscopic ventriculo-peritoneal shunt for treating patients with hydrocephalus. Methods Twenty-two cases with hydrocephalus were treated with laparoscopic ventriculo-peritoneal shunt.The drainage-tube was put into the right liver-diaphragm interspace in 9 patients and inserted into the pelvic kidney in the others. Postoperative complications, ameliorating conditions of intracranial hypertension and recovery conditions of these patients were observed. Results All the operations were succeeded and the patients got amelioration of intracranial hypertension.No complication correlating with laparoscopic surgery occured. Conclusion Laparoscopic ventriculo-peritoneal shunt have the advantages of less invasive,better intra-abdominal view and more rapid recovery than conventional laparotomy. It’s a safe and feasible method which is worth of wide using.

    Release date:2016-08-28 04:43 Export PDF Favorites Scan
  • Retrospective Comparative Study of Transumbilical Single-Incison Laparoscopic Assisted and Laparotomy Ventriculoperitoneal Shunting: A Single Center Experience

    ObjectiveTo analyze safety and feasibility of transumbilical single-incision laparoscopic assisted ventriculoperitoneal shunting. MethodsThe clinical data of 36 patients who diagnosed as hydrocephalus underwent ventriculoperitoneal shunting from May 2013 to August 2015 in this hospital were collected. Twelve patients were performed transumbilical single-incision laparoscopic assisted ventriculoperitoneal shunting (laparoscopy group) and 24 patients were performed laparotomy ventriculoperitoneal shunting (laparotomy group). The abdominal operation time, postoperative exhaust time, postoperative hospital stay, postoperative pain score, and postoperative complications rate were compared between the laparoscopy group and the laparotomy group. ResultsAll the operations were completed successfully. Compared with the laparotomy group, the abdominal operation time (P < 0.05), postoperative exhaust time (P < 0.05), and postoperative hospital stay (P < 0.05) were significantly shorter, the postoperative pain score was significantly less (P < 0.05) in the laparoscopy group. The postoperative complications rate had no significant difference between the laparoscopy group and the laparotomy group (P > 0.05). ConclusionsThe preliminary results of limited cases in this study show that transumbilical single-incision laparoscopic assisted ventriculoperitoneal shunting is safe and feasible, with better cosmetic. more comparative studies or randomized controlled trials are required to make a confirmed conclusion.

    Release date:2016-10-02 04:54 Export PDF Favorites Scan
  • 巨型基底动脉动脉瘤表现为第三脑室占位一例

    Release date:2018-06-26 08:57 Export PDF Favorites Scan
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