Clinical Effect Evaluation Of Ventriculoperitoneal Shunt In Hydrocephalus

Purpose:The aim of this retrospective analysis was to comprehensive analysis the clinical effect evaluation of ventriculoperitoneal shunting and the occurrence and prevention of complications in different etiology of hydrocephalus and different types of the shunt valve.Materials and methods:By gathering the inpatient’s information through the database management system in our hospital from November 2012 to July 2017,all of hydrocephalus patients who treated with ventriculoperitoneal shunt surgery were used to design a retrospective review.Patiens were divided into three groups by the etiology of hydrocephalus(143 cases): communicating hydrocephalus included primary communicating hydrocephalus in 28 cases(19.6%),secondary communicating hydrocephalus in 79 cases(55.2%)and obstructive hydrocephalus in 36 cases(25.2%);Types of the shunt valve(141cases): programmable valve in 82 cases(58.2%)and unadjustable valve in 59 cases(41.8%)for shunt operation.Evaluating all of the patients before,and after the shunt surgery by GCS、KPS、ADL score tables.All of the data were analysised by SPSS22.0,Rank Sum Test was applied to analyze the ranked data,significance level: α=0.05.Result:1.According to KPS score table,29 cases(29/36,80.6%)were significant effective in obstructive hydrocephalus,9 cases(9/36,25%)were cured;17cases(17/28,60.7%)were significant effective in primary communicating hydroce-phalus,11 cases(11/28,39.3%)were cured;20 cases(20/79,27.9%)were significant effective in secondary communicating hydrocephalus,9 cases(9/79,11.4%)were cured,and there was a significant difference of the operative effect between these 3groups(p<0.05),on contrary,there was no significant difference according to GCS and ADL score tables(p>0.05).Incidence of complications: 4 cases(4/36,11.1%)in obstructive hydrocephalus;8 cases(8/28,28.6%)in primary communicating hydroc-ephalus;12 cases(12/79,15.2%)in secondary communicating hydrocephalus,there was no significant difference between the three groups(p>0.05).2.According to KPS score table,50 cases(50/82,61.0%)were significant effective in patients with programmable valve,4 cases(4/82,4.9%)were cured;23 cases(23/59,39.0%)were significant effective in patients with unadjustable valve,2 cases(2/59,3.4%)were cured;according to ADL score table,38 cases(38/82,46.3%)were significant effective in patients with programmable valve,1 case(1/82,1.2%)were cured;15cases(15/59,25.4%)were significant effective in patients with unadjustable valve,5cases(5/59,8.5%)were cured,there was a significant difference of the operative effect between these 3 groups(p<0.05),on contrary,there was no significant difference according to GCS score tables(p>0.05).Incidence of complications: 9 cases(9/82,11.0%)in patients with programmable valve,15 cases(15/59,25.4%)in patients with unadjustable valve,there was a significant difference between these 2groups(p<0.05).Conclusion:1.According to KPS score table: the VP shunt operative effect of obstructive hydrocephalus was better than primary communicating hydrocephalus and than secondary communicating hydrocephalus;2.Compared with GCS and ADL score tables,KPS score table is more suitable for the clinical analysis of different types of hydrocephalus after shunt operation;3.The VP shunt operative effect of patients with programmable valve was better than unadjustable valve,and the incidence of complications in patients with programmable valve was lower.