Programmable Shunt Device를 이용한 뇌척수액 단락술의 임상적 분석
A Clinical Analysis of the Ventriculoperitoneal Shunt with Programmable Shunt Divice
소속 상세정보
한영민/Young Min Han
유도성/김달수/허필우/조경석/강준기/Do Sung Yoo/Dal Soo Kim/Phil Woo Huh/Kyung Suck Cho/Jun Ki Kang
KMID : 0359819990280010075
Abstract
결론
1) Programmable Shunt device를 이용한 뇌척수액 교통술은 션트수술후 과다 배액, 과소
배액으로 초래될 수 있는 재수술을 줄일 수 있었다.
2) 성인에서 발생한 수두증의 경우 원인에 따라 다소 차이는 있으나 적정 평균 압력은
97.4± 17.4㎜H2O로, programmable shunt device를 이용한 션트 수술시 초기
압력을 100㎜H2O로 설정하는 것이 안전하리라 사료된다.
3) Programmable shunt device는 압력 조절이 용이하여, 환자의 조기 활동이 가능하고
외래에서도 신경학적 증상과 CT검사 후 압력 조절이 가능하였다
4) Programmable shunt device를 소아에서 사용하려면 부피가 큰 밸브 부위를 개선하고,
anti-siphon effect가 추가되어야 할 것이다.
5) Programmable shunt device는 MRI시행시 전자기 조절장치로 인한 제한점과 영상 촬
영시 인공 음영(artifact)이 발생할 수 있으므로 이에 대한 임상 연구가 필요할 것으로 사료된다.
#초록#
CSF shunting procedures are widely employed in the treatment of hydrocephalus and
other disturbances of the dynamics of CSF such as arachnoid cyst and syrinx. the
relative simplicity of this operation with respect to other neurosurgical procedures is
matched by a high incidence of complications. Many kinds of shunt devices have been
developed to reduce complications. Yet, this operation frequently requires surgical
revision. Traditional shunts were primarily designed to manage hydrocephalus by
regulating intracranial pressure. Those devices, in some circumstances, can cause to
underdrain or overdrain CSF and may need a surgical revision to adjust the pressure.
Authors have treated 28 patients with the disturbaces of CSF dynamics using
pressure adjustable valve system(Codman-Medos programmable Hakim valve system).
Two patients had arachnoid cysts and the others had hydrocephalus with various
etiologies. Subdural hygroma was developed in 5 patients and underdrainage was
observed in 9 patients on CT scan. By adjusting the pressure. Authors achieved clinical
improvements without a need for surgical revision. The optimum pressure was 97.4±
17.4㎜H2O for the patients with hydrocephalus with various etiologies in
adults.
In conclusion, the incidence of shunt revision by using this shunt device for the
treatment of hydrocephalus and arachnoid cysts was decreased.
키워드
Hydrocephalus; Hygroma; Underdrain; Shunt revision; Pressure adjustable valve;
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