常规术后成像在接受初级心室关节切换的成年人中的实用性
Adnan R Alnaser1, Abed Alnsour1, Omar N Pathmanaban1
1Department of Neurosurgery, Geoffrey Jefferson Brain Research Centre, Northern Care Alliance NHS Foundation Trust, Manchester, M6 8HD, UK.
Acta neurochirurgica
|October 15, 2024
概括
常规的手术后成像,在心室外皮层 (VP) 突变插入后,很少导致成年人重新手术. 然而,紧急分流插入会显著增加后续分流修改的风险.
科学领域:
- 神经外科 神经外科
- 医疗成像医学成像
- 神经外科的结果
背景情况:
- 在成年人中插入心室外皮管 (VP) 突变器后,例行术后成像的临床实用性仍在争论中.
- 目前的文献缺乏关于立即术后成像 (CT头部扫描,X线图) 的好处的共识.
研究的目的:
- 为了评估常规术后成像在接受初级VP分流放置的成年患者的有效性.
- 为了确定常规成像是否会影响需要变送器修改或重新操作的需要.
主要方法:
- 追溯分析了在2017-2021年期间接受初级VP分流插入的236名成年患者.
- 基于常规的术后CT头部扫描和X射线图的干预措施的跟踪.
- 记录后续的突变修订率和相关的临床因素.
主要成果:
- 根据术后CT扫描,只有3.9%的患者需要急性干预;X射线图没有促使重新手术.
- 大约28.8%的患者需要分流修复,主要是那些急需初级插入的患者.
- 无论是心室导管特征还是成像检测结果都没有预测冲刺修订;手术紧急性是一个显著的预测因素 (OR=2.80).
结论:
- 在成年人进行初级VP分流插入后的例行术后成像在触发重新手术方面具有有限的效用.
- 紧急的VP分流插入是长期分流修改的关键风险因素,独立于常规成像发现.
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