Development and Clinical Application of Anti-Slit Ventricular Catheter.

目前脑积水的治疗仍停留在分流依赖性脑积水的外科治疗上，因此，开发一种新的分流系统，使脑脊液引流能够在更符合生理的条件下进行控制，是一个迫切的问题。本研究的目的是研制一种分流导管系统，以防止分流依赖性条件下脑室系统发生裂隙样改变，本研究分为两部分，一部分是胎鼠脑积水模型的建立，另一部分是硅橡胶脑室模型的研制和实验应用。在前者中，在6-AN诱导的大鼠胎仔中形成脑积水，并放置胎-脑室=母体-腹膜分流。实验结果揭示了导水管继发性梗阻致第四脑室分离及幕上脑室系统裂隙样改变的可能机制。为了证明这一机制，开展了后期的实验研究。该脑室系统仿真模型由两个侧脑室、第三和第四脑室以及各自的连接通路组成。e.一侧侧脑室放置规则脑室导管（Pudenz脑室导管），另一侧侧脑室放置反缝脑室导管。同时，在每根导管引流脑脊液时进行双侧脑室内压监测。实验结果证实了使用抗裂脑室导管时能很好地保持脉压，证明了抗裂脑室导管的有效性，并分析了分流术后裂状脑室和孤立脑室的生理机制，圆满完成了本课题。

It is an urgent problem to develop a new shunt system in which CSF drainage can be controlled in more physiological condition, as far as the present status of hydrocephalus treatment remains in shunt dependent arrested hydrocephalus as the goal of the surgical intervention. The purpose of this research is to develop a shunt catheter system which prevent the ventricular system to change to slit-like configulation as a result of shunt-dependent condition.The research project was devided into two parts, one with an experimental model of rat-fetus hydrocephalus and the other with development and experimental use of silicone ventricular model. In the former, 6-AN induced hydrocephalus was developed in rat fetuses and fetus-ventriculo=mater-peritoneal shunt was placed. The experiment results revealed some suggestive mechanism for isolated fourth ventricle due to secondary obstruction of the aqueduct together with supra-tentorial ventricular system changed to slit-like. To prove this mechanism, the later experimental study was developed. This simulation model of the ventricular system was consisted of two lateral ventricles, third and fourth ventricles with individual connective pathways, i. e. foramen of Monro, aqueduct of Sylvius, central canal of the spinal cord and so on. One lateral ventricle was placed a regular ventricular tube (Pudenz ventricular catheter) and the other was shunted with an anti-slit ventricualr catheter. At the same time, bilateral intraventricular pressure monitoring was performed during CSF draingae by each catheter. The results confirmed well preserved pulse pressure when the anti-slit ventricular catheter was used.The research project was satisfactorily completed with this proof of efficacy of anti-slit ventricular catheter together with the analysis of physiological mechanisms of post-shunt slit-like ventricle and isolated ventricles.