摘要： 目的 探讨两种手术方式治疗交通性脑积水之疗效和并发症。方法 分别采用脑室-腹腔分流术或腰大池-腹腔分流术治疗43例交通性脑积水患者，比较其疗效和并发症发生率。结果 两种术式疗效比较，差异无统计学意义（均P > 0.05），但脑室-腹腔分流术组癫［36.36%（8/22）对0，P = 0.008］、感染［36.36%（8/22）对4.76%（1/21），P = 0.030］、颅内出血［27.27%（6/22）对0，P = 0.032］等并发症发生率高于腰大池-腹腔分流术组。结论 腰大池-腹腔分流术治疗交通性脑积水之疗效优于脑室-腹腔分流术，大多数患者可以腰大池-腹腔分流术替代脑室-腹腔分流术。

关键词: 脑积水, 脑室腹膜分流术, 手术后并发症

Abstract: Objective  To explore the therapeutic effects and complications of two kinds of surgical procedures for the treatment of communicating hydrocephalus.  Methods Ventriculoperitoneal shunt (VPS) and lumboperitoneal shunt (LPS) were respectively adopted to treat 43 cases of communicating hydrocephalus. The therapeutic effects and complications were analyzed, and related literatures were reviewed.  Results  No significant difference was found between 2 groups in therapeutic effects, such as alleviating headache, improving intelligence and ventricle shrinking (P > 0.05, for all). The incidence of complications of ventriculoperitoneal shunt, mainly including epilepsy [36.36% (8/22) vs 0, P = 0.008], infection [36.36% (8/22) vs 4.76% (1/21), P = 0.030], intracranial hemorrhage [27.27% (6/22) vs 0, P = 0.032], and so on was significantly higher than that of lumboperitoneal shunt.  Conclusions  For communicating hydrocephalus, the effect of lumboperitoneal shunt is better than that of ventriculoperitoneal shunt, so the latter can be replaced by the former in most cases, except for infection or serious abnormality at operative site.

Key words: Hydrocephalus, Ventriculoperitoneal shunt, Postoperative complications