Systematic review of the outcome of shunt surgery in idiopathic normal-pressure hydrocephalus
Systematic review of the outcome of shunt surgery in idiopathic normal-pressure hydrocephalus
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DOI：
10.1007/s00701-013-1835-5
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发表时间：
2013-10-01
影响因子：
2.4
通讯作者：
Watkins, Laurence D.
中科院分区：
文献类型：
--
作者：
Toma, Ahmed K.;Papadopoulos, Marios C.;Watkins, Laurence D.
据报道，特发性常压脑积水的早期外科系列分流术短期改善率低，死亡率和发病率相对较高；随后，对于风险-收益比有利的患者，建议进行分流插入。对客观评估特发性常压脑积水分流术置入后疗效的研究进行了文献检索；目的是根据改善率和相关的死亡率和发病率来估计分流器插入的结果。共回顾了64项研究，3063例患者。在分流器插入后，平均71%的患者报告了积极的改善，平均死亡率为1%。过去5年发表的研究结果显示，分流器置入后的改善率为82%，死亡率为0.2%，合并常见并发症发生率为8.2%。当患者选择得当，分流插入是一种安全有效的特发性常压脑积水管理与长期积极的结果。
Early surgical series of shunt insertion for idiopathic normal-pressure hydrocephalus reported a low rate of short-term improvement with a relatively high rate of mortality and morbidity; subsequently shunt insertion was recommended for patients in whom there is favourable risk-to-benefit ratio.Bibliographic search for studies that objectively assessed the outcome following shunt insertion in idiopathic normal-pressure hydrocephalus was done; the aim was to estimate the outcome of shunt insertion in terms of improvement rates and associated mortality and morbidity.A total of 64 studies of 3,063 patients were reviewed. Positive improvement following shunt insertion was reported in an average of 71 % of patients with an average 1 % mortality. Results from studies published in the last 5 years showed 82 % improvement following shunt insertion, mortality of 0.2 %, and combined common complications rate of 8.2 %.When patients are properly selected, shunt insertion is a safe and effective management of idiopathic normal-pressure hydrocephalus with a prolonged positive outcome.