Outcome predictors for normal-pressure hydrocephalus.
Outcome predictors for normal-pressure hydrocephalus.
复制标题
正常压力脑积水的结果预测因素。
DOI：
10.1007/3-211-30714-1_75
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发表时间：
2006
期刊：
影响因子：
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通讯作者：
W. Steudel
中科院分区：
文献类型：
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作者：
M. Kiefer;R. Eymann;W. Steudel
这项前瞻性研究的目的是寻找预后预测因素，以便更好地选择治疗正常压力脑积水(NPH)患者。共有125名患者接受了评估并接受了重力分流。如果采用压力/容量指数为30毫升或流出阻力为13毫米汞柱/毫升×分钟的分流算法，脑脊液流体动力学可提供更好的预测值。总体而言，随着病史持续时间的延长、术前临床状态的恶化和并发症的增加，预后变得更差。如果这些参数中的一个低于临界值，分流应答率约为90%，通常看不到老年的负面影响。众所周知的NPH预后更差的范例并不是脑积水病因本身的结果，而是由于误解了正常衰老和延迟适当的治疗而导致的典型的负面结果预测因素的累积的结果。
The objective of this prospective study was to find outcome predictors for better selection for treatment of normal-pressure hydrocephalus (NPH) patients. A total of 125 patients were evaluated and provided with a gravitational shunt. Cerebrospinal fluid hydrodynamics provided better predictive values if an algorithm to shunt all patients with a pressure/volume index of < 30 mL or resistance to outflow > 13 mmHg/mL x min was used. In general, outcome became worse with increasing anamnesis duration, worse preoperative clinical state, and increasing comorbidity. If one of these parameters was lower than a critical value, the shunt-responder rate was about 90% and the normally negative influence of older age was not seen. The well-known paradigm of a worse prognosis with NPH is not the result of the hydrocephalus etiology itself, but the consequence of a typical accumulation of negative outcome predictors as a consequence of the misinterpretation of normal aging and delayed adequate treatment.