脑室-腹腔分流术治疗小儿脑积水并发症研究

《脑室-腹腔分流术治疗小儿脑积水并发症研究》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、脑室-腹腔分流术治疗小儿脑积水并发症研究［摘要］目的分析脑室-腹腔分流术（VPS）治疗小儿脑积水的并发症。方法脑积水患儿185例，所有患儿均行VPS治疗。术后通过门诊和电话定期对患儿进行随访，记录并分析患儿并发症诊治情况和原因，统计并发症的发生率。结果157例患儿术后无并发症发生，28例患儿术后出现并发症，发生率为15.14%o主要并发症为分流管阻塞（4.9%）和感染（4.3%）,主要阻塞原因为脑室粘连、纤维组织阻塞、管口滑落脑室腔外、管口囊肿包裹和大网膜包裹，主要感染因素为迁延性脑膜炎、皮下积液、皮肤破溃和肠道逆行感染。结论VPS治疗小儿脑积水术后并发症以分流管阻

2、塞和感染多见，有效预防和治疗并发症可提高VPS术后疗效。［关键词］脑室-腹腔分流术；脑积水；儿童；并发症［中图分类号］R726.1［文献标识码］A［文章编号］1674-4721(2012)07(b)-0057-02Analysisofcomplicationsofventriculo-peritonealshuntinthetreatmentofpediatrichydrocephalusFENGShubinLUShanQILinDepartmentofNeurosurgery,Children"sHospitalofZhengzhouCityinHe"nanPro

3、vince,Zhengzhou450053,China[Abstract]ObjectiveToanalyzethecomplicationsofventriculo-peritonealshuntinthetreatmentofpediatrichydrocephalus・MethodsOnehundredandeighty-fivecasesofhydrocephaluschildrenweretreatedwithventriculo-peritonealshunt(VPS).Allchildrenwerefollowedupafteroperationbym

4、eansofoutpatientserviceandtelephone,thediagnosisandtreatmentsituationofcomplicationsofchildrenwasrecordedandthereasonswereanalyzed,theincideneeofcomplicationswasdonestatistics.ResuItsOnehundredandfifty-sevencasesofchildrenhadnoincidenceofcomplications,and28casessufferedwithcomplication

5、safteroperation,theincidenceratewas15.14%.Shunttubeobstruction(4.9%)andinfection(4.3%)werethemaincomplications.Ventricleadhesion,fibreobstruction,shunttubeslidingoutofventricularcavity,tubemouthcystandtubeparcelwerethemainreasonsofobstruetion.Chronicmeningitis,subcutaneouseffusion,skin

6、ulcerationandintestinalretrogradeinfectionwerethemainreasonsofinfection.ConclusionShunttubeobstructionandinfectionarethemainpostoperativecomplicationsofVPSinthetreatmentofpediatrichydrocephalus.EffectivepreventionandtreatmentofcomplicationscanenhancethepostoperativeeffectofVPS.[Keyword

7、s]Ventriculo-peritonealshunt；Hydrocephalus；Children；Complications脑积水是小儿神经外科常见疾病之一。由于脑脊液循环通路阻塞使脑脊液在颅内大量积聚，而导致脑室进行性扩大，脑室周围组织缺血缺氧、水肿变性，引起大脑发育不良和各种神经功能障碍，影响患儿生长发育和身心健康，如何有效治疗脑积水是儿科临床医生十分关注的问题[1]。目前,手术是治疗小儿脑积水最有效的方法，特别是脑室-腹腔分流术(ventriculoperitonealshunting,VPS)创伤小、操作简单，可以解除脑脊液循环障碍，使脑脊液的分泌