| Background:Hydrocephalus is a common and frequently-occurring disease in neurosurgery.It can cause secondary neurological impairment in patients.In severe cases,it can cause patients' death and disability.At present,the common operative method is Ventriculoperitoneal shunting(V-P shunting).However,V-P shunting can also lead to many complications,such as infection,mechanical complications,abdominal complications and so on.Although the current surgical technique,shunt devices,and treatment methods have developed rapidly,the rate of complications remained high.The purpose of this article is to analyze the data of hydrocephalus patients who undergo V-P shunting in our hospital,and adds further clinical data to the postoperative complications.Objective:The composition of postoperative complications of patients with hydrocephalus undergoing V-P shunt and their prevention and treatment were analyzed in order to provide a scientific basis for improving the curative effect of V-P shunt in treating hydrocephalus.Methods:The clinical data of 86 hydrocephalus patients undergoing Ventriculo-peritoneal shunting from January 2011 to December 2017 in the First Affiliated Hospital of Xiamen University were retrospectively analyzed.Among them,15 cases were missed and 71 cases were effective.Among 71 cases,40 were male(56.3%),31 were female(43.7%),12(16.9%)were young(<18 years old),59(83.1%)were adult(?18 years old),and there were 34 patients(47.9%)with other surgical operations in brain before the shunt,and 37(52.1%)patients without any surgery.The age ranged from four months to 80 years and the average age was 40.06±23.27 years.All patients underwent Computed tomography(CT)or Magnetic Resonance Imaging(MRI)examination before the operation,and hydrocephalus was diagnosed according to imaging criteria.V-P shunting was performed during the operation.Among them,66 patients(93%)were treated with anterior surgical approach,52 patients with right frontal angle,12 patients with left frontal angle,and 2 with dual-frontal angles.5 cases were treated with occipital angle approach(7%,1 case with left occipital,4 cases with right occipital).The follow-up time ranged from 2 months to 77 months and the average follow-up time was 34.76±21.43 months.Postoperative complications were observed and analyzed in order to evaluate the clinical effect of V-P shunting for patients with hydrocephalus.Result:(1)During the follow-up period,11 patients(15.5%)died due to the severe primary disease or tumor recurrence,and 14 patients(19.7%)had complications.Among them,6 patients(8.5%)had shunt infection,3 cases(4.2%)had shunt obstruction,2 cases(2.8%)had shunt obstacle,1 case had shunt(1.4%)migration,and 1 case(1.4%)had excessive drainage,1 case with underdrainage(1.4%).No complication occurred in 36 cases(50.7%).Postoperative pressure adjustment was performed in 9 cases(12.7%).(1.4%),the ventriculoperitoneal shunt revision was implemented in our hospital after abdominal shunt infection in one postoperative patient of other hospital.(2)The incidence of complications after shunt in young and adult was P<0.05,in patients with surgical operation before shunt and without surgical operation before shunt was P<0.05.Conclusion:(1)The ventriculoperitoneal shunt is an effective method for the treatment of hydrocephalus patients,but the rate of postoperative complications is still high.(2)Patient's age and the brain surgery before the operation has a connection with the occurrence of postoperative complications.Patients who were younger or had a brain surgery before the operations were more likely to undergo complications.(3)Mastering the indication of operation,improving surgical skill,choosing proper shunt device and shunt pressure,and dealing with complications effectively and actively after operation can reduce the occurrence of complications. |
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