The Diagnosis And Treatment Of Normal Pressure Hydrocephalus And Related Factors Affecting Surgical Effect

Objective: To explore the diagnosis of normal pressure hydrocephalus,the selection of surgical cases and related factors affecting the effect of ventricular shunt,and provide a reference for the treatment of normal pressure hydrocephalus.Methods: A total of 40 patients who were diagnosed as normal pressure hydrocephalus and ventriculoperitoneal shunt were collected between August 2015 and December 2017 in the hospital of the affiliated general hospital of xxxxxx and the hospital of xxxxxx.Spontaneous intracerebral hemorrhage: 11 cases.Traffic injuries: 6 cases.No obvious inducement: 18 cases.Fall injury: 2 cases.Postoperative intracranial tumor:3 cases.Follow up the patient through outpatient service or telephone.The follow-up was based on the patient’s self-assessment or Family members’ assessment of the patient’s general condition.Using GOS score to assess the secondary normal pressure hydrocephalus and Rakin score to assess the idiopathic normal pressure hydrocephalus.as the final prognostic criteria.The prognosis of postoperative patients was evaluated by 6months after operation,and the improvement of clinical symptoms was evaluated,and the general clinical data of patients were statistically analyzed.Result:Among the 22 patients with secondary normal pressure hydrocephalus,1 patient died of septic shock caused by pulmonary infection.One patient developed intracranial infection,and after active anti-infection treatment,the symptoms improved.The average GOS score of the secondary normal pressure hydrocephalus was increased from 3.14 + 0.66 to 3.71 + 1.01 in 6 months after the shunt.(Paired t test,p < 0.05.).According to the improvement of GOS score before and after surgery,it was concluded that ventriculo-peritoneal shunt was effective in improving the prognosis of patients.the patient were divided into prognosis improved group and unimproved group based on the improvement of GOS score before and after surgery.To compare the clinicalfeatures and general data differences between the two groups.The preoperative mean GOS score was greater than the unimproved group and the difference was statistically significant.There was no statistical difference between the two groups in terms of age,sex,preoperative Lumbar puncture pressure,time of onset,and degree of hydrocephalus.The average Rakin score of the patients with idiopathic normal pressure hydrocephalus decreased to 1.22 + 0.81 from 2.94 + 0.94 before surgery.(Paired t test,p < 0.05)The decrease of Rakin score was greater than 2 in the preoperative period,suggesting that the ventriculoperitoneal shunt was effective in improving the prognosis of patients.the time of onset of the improved group was lower than the unimproved group and the difference was statistically significant.There were no statistically significant differences between the two groups in age,gender,preoperative Lumbar puncture pressure and hydrocephalus.From the analysis results,the higher GOS score of patients with secondary normal pressure hydrocephalus was more likely to benefit from ventricular shunt.The patient with idiopathic normal pressure hydrophalus,the shorter the onset time,the more likely it is to benefit from ventricular shunt.Conclusion:In this study,40 patients with normal pressure hydrocephalus were evaluated for 6 months after operation.Twenty-three patients were considered to be effective in improving prognosis.The improvement rate was 58.97%.The general characteristics and clinical data of patients were further analyzed shows that patients of secondary normal pressure hydrophalus with higher GOS scores before surgery and patients with idiopathic normal pressure hydrocephalus with short onset time is more likely to benefit from ventricular shunt.