Curative effect and complication analysis of different shunt procedures for treatment of posttraumatic hydrocephalus / 中华创伤杂志

ABSTRACT

Objective To compare the effect and complications of lumboperitoneal shunt (LP) and ventriculoperitoneal shunt (VP) in treatment of posttraumatic hydrocephalus (PTH).Methods A retrospective study was made on 150 cases of posttraumatic communicating hydrocephalus managed with LP or VP from June 2013 to June 2015.There were 65 cases [36 males, 29 females;(47.2 ±8.2) years of age] in LP group and 85 cases [53 males, 32 females;(44.6 ± 7.3) years of age] in VP group.Therapeutic effect and complications were analyzed postoperatively.Results Period of follow-up was 3-27 months, which shoued Total effective rate of 97％ in LP group and 94％ in VP group (P ＞0.05).Postoperative complications were mainly hematoma, infection, shunt obstruction, shunt exposure, excessive shunt and inadequate shunt.At the follow-up, there were 3 subdural hematoma, 4 intracranial infection, 2 shunt obstruction, 3 excessive shunt and 1 inadequate shunt in VP group, but 1 subdural hematoma, 1 intracranial infection, 1 shunt exposure and l excessive shunt in LP group.Good results were achieved in the two groups after regulation of the shunt pressure or reoperation.In comparison, incidence of complications was 6％ in LP group versus 15％ in VP group (P ＜ 0.05).Rate of shunt removal and reoperation in LP group were both 2％, but were 7％ and 8％ respectively in VP group (P ＜ 0.01).Conclusions Both shunt procedures are effective for posttraumatic hydrocephalus, while LP is a better choice in clinical application for the lower complication incidence, shunt removal rate and reoperation rate.