脑室-腹腔分流术治疗小儿脑积水  

Ventriculoperitoneal Shunt in Pediatric Hydrocephalus

作　　者：沈玉成[1,2,3] 陈若平[1,2,3] 严文波[1,2,3] 方立浩 冯洁 

机构地区：[1]上海第二医科大学附属新华医院小儿外科 [2]上海市儿童医院小儿外科 [3]无锡市北塘人民医院小儿外科

出　　处：《中华小儿外科杂志》1998年第4期201-203,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的：对脑室－腹腔分流术治疗小儿脑积水进行评价。方法：本组２１０例脑先天性畸形、炎症性及肿瘤性所致的脑积水，均采用脑室－腹腔分流术，分流管以Ｐ．Ｓ．、９００３、Ｂ．Ｃ．Ｅ．三种为优。结果：４８例有并发症（２１．９０％），其中脑室端阻塞８例（３．８５％），腹腔端阻塞４例（１．９０％），脑室无扩大亦无缩小者８例（３．８５％），分流管退出腹腔６例（２．８５％），并发细菌性感染６例（２．８５％），硬膜下血肿６例（２．８５％），鞘膜积水５例（２．３８％），分流管进入阴囊２例（０．９５％），脑肿瘤细胞循分流管进入腹腔而种植于右下腹２例（０．９５％），腹腔内囊肿形成１例（０．４７％）；２例因感染死亡，病死率０．９５％。结论：脑室－腹腔分流术是治疗小儿交通性脑积水及阻塞性脑积水迄今为止最优的方法，但必须严格选择病例，术前脑室测压实属必要。术后脑积水获得纠正后。Objective: To evaluate the effect of ventriculoperitoneal shunt in pediatric hydrocephalus. Materials: Two hundred and ten cases of hydrocephalus resulted from congenital malformation, infection, or tumor of brain were studied. All cases were treated by ventriculoperitoneal shunt. PS. 9003 and B.C.E. tubes were the priority of choice. Results: Postoperative complications were found in 48 of the 210 cases (21.90%). They were obstruction of ventricular end of the tube in 8 cases (3.85%), obstruction of peritoneal end in 4 (1.90%), no ehange in ventricles in 8 (3.85%), extraction of peritoneal end in 6 (2.85%), bacterial contamination in 6 (2.85%), subdural hematoma in 6 (2.85%), hydrocele tunica vaginalis in 5 (2.38%), peritoneal end into scrotum in 2 (0.95%), brain tumor cell implanation in right lower abdomen in 2 (0.95%), cyst in abdomen in 1 (0.47%), and 2 died of infection (0.95%). Conclusions: The VP shunt is still the choice of treatments for pediatric hydrocephalus and most cases recover to have a normal life. The indications of operation and prevention of complications are emphasized.

关 键 词：脑积水 分流术 脑室-腹腔分流 儿童 

分 类 号：R742.705[医药卫生—神经病学与精神病学] R748.05[医药卫生—临床医学]