目的 探讨成人脑积水术后脑室-腹腔分流管断管的原因及处理策略.方法 回顾性分析2例成人脑积水术后分流管断裂患者的临床资料.并结合文献分析术后分流管系统连接中断的相关因素,以及对分流管连接中断的预防、诊断及处理方法.结果 1例患者女性,36岁;1例患者男性,33岁;分别于术后5年、3年发生断管(均在颈部活动时);主要表现为头痛及颈部包块.经腹部X线片或CT检查示,腹腔端引流管脱落.均予以腹腔镜下取出原有引流管,重新置入分流管;术后患者症状均消失.结论 成人脑室-腹腔分流管连接中断的发生率低,但可导致严重的并发症.其与生长发育、颈部活动、宿主反应、分流管系统退化、手术操作、外伤等因素相关,通过X线片、CT重建、放射性核素以及手术探查等方式明确断管位置,并及时采取相应的处理.%Objective To explore the causes and treatment strategies for fractured adult ventriculoperitoneal shunt systems.Methods The clinical data of 2 patients with postoperative ventriculoperitoneal shunt fractures were analyzed retrospectively.The literature on this complication were reviewed and prevention and treatment strategies were explored.Results 1 female patient was 36 years old and 1 male patient was 33 years old.Shunt tube rupture occurred 5 years and 3 years after operation respectively ( all occurred when the neck was active ).Abdominal X-ray or CT scan showed that the shunt tube fell off to the abdomen.The original shunt tube was removed under laparoscopy and re-implant shunt tube.Then the patients 'symptoms disappeared after operation.Conclusions The incidence of adult ventriculoperitoneal shunt pipe fracture is very low,though it is a serious complication.Many factors cause the shunt fracture,including growth,neck activity,host responses,system degradation,surgical operation and trauma.We can make broken tube positions clear by using x-ray,CT,radionuclide,and surgical exploration methods,in order to achieve long-term patient rehabilitation.
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