Comparison of efficacy between lumbo-peritoneal shunt and ventriculoperitoneal shunt in treating communicating hydrocephalus after cerebral hemorrhage

Chen Guiming; Zhang Huiyu; Ma Huaibin

doi:10.11850/j.issn.1009-122X.2025.04.003

Abstract：Objective To compare the efficacy and complications between lumbo-peritoneal shunt(LPS)and ventricular-peritoneal shunt(VPS)in patients with communicating hydrocephalus after cerebral hemorrhage.Methods The clinical data of 80 patients with communicating hydrocephalus after cerebral hemorrhage were analyzed retrospectively.According to different surgical methods,the patients were divided into LPS group(n=36,treated with LPS)and VPS group(n=44,treated with VPS).The one-time success rate,perioperative indicators(operative time,intraoperative blood loss,hospitalization time),complications,changes in red blood cell distribution width(RDW)and fibrinogen(FIB)before surgery and at 1 week after surgery,changes of Glasgow Coma Scale(GCS)and Evans Index(EI)before surgery and at 6 months after surgery and disease outcomes were compared between groups.Results The one-time surgical success rate was 91.67%in the LPS group and 72.73%in the VPS group,with the LPS group significantly higher than the VPS group(P<0.05).Compared with the VPS group,the LPS group had a significantly shorter operative time and less intraoperative blood loss(both P<0.05),while there was no significant difference in the length of hospital stay between the two groups(P>0.05).The overall complication rate was 8.33%in the LPS group and 27.27%in the VPS group,with the LPS group significantly lower than the VPS group(P<0.05).One week after surgery,both RDW and FIB levels significantly decreased in both groups compared with preoperative levels,and the LPS group had significantly lower levels than the VPS group(both P<0.05).Six months after surgery,both GCS scores significantly increased and EI scores significantly decreased in both groups compared with preoperative levels(both P<0.05).The GCS score,EI score and GCS clinical significant improvement rate in LPS group were significantly different from those in VPS group(P<0.05).There was no significant difference in the significant improvement rate of postoperative imaging between groups(P>0.05).Conclusions Compared with VPS,LPS is less technically challenging,has a higher one-time success rate,and fewer complications in the treatment of communicating hydrocephalus following cerebral hemorrhage,and is more conducive to postoperative recovery of patients.