Comparative Study Of Lumbar Cisterna-peritoneal Shunt And Lateral Ventricle Celiac Shunt For Traffic Hydrocephalus

Objective:By studying and comparing two treatment methods of communicating hydrocephalus patients:ventriculoperitoneal shunt and lumbar cisterna-peritoneal shunt,respectively,the operation time,postoperative recovery,postoperative complications(blockage,valve blockage,abdominal encapsulation,infection,catheter,subdural effusion,hemorrhage,intracranial hemorrhage,etc.),a series of indicators,such as secondary operation rate,surgical effect of coma patients,etc.To evaluate the difference between ventriculoperitoneal shunt and lumbar cisterna-peritoneal shunt in the treatment of communicating hydrocephalus,and to provide some reference value for clinical surgical treatment selection.Methods:The data of 45 patients with communicating hydrocephalus admitted to neurosurgery of the Second Affiliated Hospital of Kunming Medical University from January 2017 to July 2019 were collected retrospectively.After all patients were admitted to hospital,brain CT,MRI,lumbar puncture and other related examinations were completed,and surgical treatment was performed according to the wishes of patients and their families.According to the different operation methods,26 cases were divided into ventriculus group and 19 cases into lumbar cistern group.The data of age,gender,etiology,state of consciousness,operation time,operation effect,postoperative complications(infection,blockage,improper drainage,intracranial hemorrhage,etc.),secondary operation rate and coma effect of the two groups were compared.Spss25.0 statistical software analysis was used.The measurement data was expressed by mean ± standard deviation.T-test was used to compare and count The data were expressed as percentage and compared with chi square test.P<0.05 was statistically significant.Results:Compared with the data of the two groups,the differences in gender,age and consciousness were 0.878,0.794 and 0.915,respectively,P values were greater than 0.05,no significant difference.The differences in the postoperative causes of trauma,tumor,intracranial infection and cerebrovascular disease were 0.912,0.237,0.915 and 0.651,respectively,P values were greater than 0.05,no significant difference.The head of the ventricles in the lumbar cistern group was longer than that in the operation time(118±6 vs 72±3),t=5.787,P<0.0001,with a significant difference;the excellent and good rate of surgical effect in the upper ventricle group was lower than that in the lumbar cistern group(73.08%vs 78.95%),Chi square value was 0.205,P=0.651,greater than 0.05,the difference was not statistically significant:postoperative complications in the upper lumbar cistern group were lower than those in the ventriculum group(15.79%vs 46.15%),chi square value was 4.555,P=0.033,less than 0.05,the difference was statistically significant;the second operation rate in the ventriculum group was higher than that in the lumbar cistern group(23.08%vs 5.26%),chi square value is 2.652,P value is 0.103 more than 0.05,the difference is not statistically significant;comatose patients' curative effect comparison is the improvement of consciousness and limb movement ability,ventricle group vs lumbar cistern group(33.33%vs 0%),chi square value is 0.833,P value is 0.361 more than 0.05,the difference is not statistically significant;ventricle improvement,ventricle group vs lumbar cistern group(100%vs 50%),chi square value is 1.875,P value is 0.171 is greater than 0.05,the difference is not statistically significant.Conclusion:Comparing the two drainage methods in the treatment of communicating hydrocephalus,the lumbar cisterna-peritoneal shunt group had shorter operation time,higher excellent and good therapeutic effect,lower complication rate and lower probability of second operation,but the treatment effect on comatose patients was worse than that of ventriculoperitoneal shunt.Overall,combined with the development status of neurosurgical technology and materials,although ventriculoperitoneal shunt has long been the preferred surgical method for hydrocephalus and has been used more widely and maturely,lumbar cistern-peritoneal shunt has obvious advantages in the treatment of communicating hydrocephalus,whether it shortens the operation time,improves the postoperative efficacy,or reduces complications and secondary surgery,and it has obvious advantages in clinical work.In the treatment of communicating hydrocephalus,it can be preferred.