儿童脑积水脑室腹腔分流术100例预后分析(英文)  

Prognostic analysis of 100 cases of pediatric hydrocephalus after ventriculo-peritoneal shunting

作　　者：刘辉[1,2] 贺晓生[2] 陈伟[2] 费舟[2] 刘卫平[2] 付洛安[2] 章翔[2] 

机构地区：[1]邯郸市第一医院神经外科,河北邯郸056002 [2]第四军医大学西京医院神经外科,陕西西安710032

出　　处：《中华神经外科疾病研究杂志》2011年第2期137-143,共7页Chinese Journal of Neurosurgical Disease Research

基　　金：National Natural Science Foundation of China(No.30971173)

摘　　要：目的通过分析接受脑室腹腔分流手术（VPS）的儿童脑积水患者的预后情况,探讨预后相关因素及其治疗措施。方法本研究共包括100例2006年至2010年接受VPS的儿童脑积水患者（3个月至15岁）。术后3个月至5年进行初次随访,对患者的人口学特征、临床表现、外科措施等资料进行分析。结果头颅增大、头痛、步态不稳为术前三大主要症状,分流术后87.5%患者头痛改善,头颅缩小者35.2%。在前三年随访中全部患者（各种程度）的脑室缩小率超过80%,脑室增大者1%－2%。随访期内患者自评或监护人针对患者症状评价的改善率为35.2%－87.5%,平均69%。分流术后各种并发症发生率为44%,死亡率为3%。结论分流手术的疗效需进行长期观察,CT或MRI显示脑室缩小是分流术后效果良好的直接证据,但不是唯一证据。在评价分流手术最终预后时不能忽略症状和体征的改善。Objective To explore prognosis-related factors and relative therapeutic strategies by analyzing the prognosis of pediatric patients with hydrocephalus treated by ventriculo-peritoneal shunting （VPS）.MethodsThe study included 100 cases of pediatric patients （aged 3 months to 15 years） treated with ventriculo-peritoneal shunting from 2006 to 2010. Follow-up was carried out 3 months to 5 years postoperation in order to get the demographic characteristics, clinical manifestations and surgical procedures.Results Large head, headache, imbalanced gaits were the triad of hydrocephalus preoperation. Headache improved in 87.5% patients and head circumference decreased in 35.2% patients postoperation. The shrinkage rate of enlarged cerebral ventricles was over 80% and the enlargement of cerebral ventricles presented in 1%-2% patients during the first 3 years＇ follow-up. The total rate of self-evaluated or gardians-evaluated improvement accounted for 69% （35.2%-87.5%） in the period of follow-up. The post-shunting complications occurred in 44% of patients （person-time） and only 3% died. Conclusion The therapeutic efficiency needs long-term evaluation. The shrinkage of cerebral ventricles shown by CT or MRI is a direct evidence of improvement post shunting but not the unique one. Improvements in clinical symptoms and signs should not be neglected while evaluating the final effects of shunting operations.

关 键 词：儿童脑积水 脑室腹腔分流术 预后 

分 类 号：R651.1[医药卫生—外科学]