Study on the efficacy of LPS and VPS with adjustable pressure shunt in patients with communicating hydrocephalus WU Bo，DENG Da，WANG Weibo Ziyang Hospital Affiliated to Chengdu University of traditional Chinese Medicine，Ziyang 641300，China Corresponding author：WU Bo 【Abstract】 Objective To explore the efficacy of adjustable pressure shunt lumbar peritoneal shunt（LPS）and lateral ventriculoperitoneal shunt（VPS）in patients with communicating hydrocephalus，serum red blood cell distribution width（RDW），central nervous system specific protein（S100B），transformation Analysis of the influence of growth factor-β1（TGF-β1）and prognostic factors. Methods A total of 300 patients with traffic-related hydrops who were admitted to our hospital from January 2018 to November 2021 were prospectively selected as the research subjects. According to the random number table method，300 patients were randomly divided into the study group and the control group，150 cases in each，the control group was treated with VPS，and the study group was treated with LPS. The curative effect，Canadian Neurology Scale（CNS），Modified Rankin Scale（mRS）score，RDW，S100B，TGF-β1 levels and postoperative complications at 1 week after operation were compared between the two groups. According to whether delayed intracranial hemorrhage （DICH） occurred after operation，the patients were divided into DICH group and non-DICH group. Binary Logistic regression was used to analyze the influencing factors of DICH. Results There was a significant difference in the therapeutic efficacy between the two groups，and the treatment group in the study group was higher than that in the control group（93.33% vs 83.33%）（χ2 =7.278，P<0.05）. After treatment，the CNS scores in both groups were significantly increased（7.96±0.81 vs 5.06±0.56/7.01±0.69 vs 5.05±0.65），and the mRS scores were significantly decreased（2.03±0.42 vs 4.07±0.65/2.85±0.39 vs 3.98±0.55）（t=16.213/11.353，32.285/9.281，P<0.05），and the CNS score of the study group（7.96±0.81 vs 7.01±0.69）was higher than that of the control group，and the mRS score （2.03±0.42 vs 2.85±0.39）were lower than the control group（t=10.935，17.522，P<0.05）. Compared with before treatment（2.21±0.31/2.22±0.34，16.35±2.34/16.87±2.26，2718.50±703.58/2798.08±729.76），the levels of s100B，RDW and TGF-β1 in the two groups after treatment（1.28±0.27/1.73±0.32，12.58±1.58/14.28±1.55，1664.76±625.59/2304.26±692.44）were significantly decreased（t=27.707/12.853，16.313/11.575，13.708/6.012，P<0.05），and the study group s after treatment，RDW，TGF-β1（1.28±0.27，12.58±1.58，1664.76±625.59）were lower than those in the control group （1.73±0.32，14.28±1.55，2304.26±692.44）（t=13.163，9.407，8.393，P<0.05）. The incidences of postoperative DICH and total complications in the study group were lower than those in the control group（χ2 =14.451，P<0.05）. Multivariate Logistic regression analysis showed that age，diabetes mellitus，hypertension，adjustment of shunt valve within 1 week after operation，and postoperative subdural effusion were all related factors for postoperative DICH in patients with communicating hydrocephalus（P<0.05）. Conclusion Compared with VPS，the adjustable pressure shunt LPS has better effect in the treatment of communicating hydrocephalus，which can effectively improve the nerve damage of patients，reduce the levels of RDW，S100B，TGF-β1，and reduce the incidence of postoperative complications. In addition，advanced age，diabetes，hypertension，adjustment of shunt valve within 1 week after operation，and postoperative subdural effusion are all related risk factors for postoperative DICH in patients with communicating hydrocephalus. 【Key words】 Communicating hydrocephalus；Adjustable pressure shunt lumbar peritoneal shunt；Lateral ventricle peritoneal shunt；Red blood cell volume distribution width；S100B；Transforming growth factor-β1；Prognosis
