三脑室底造瘘术和脑室腹腔分流术治疗儿童脑积水疗效分析  

Analysis of the efficiency of three ventriculostomy and ventriculoperitoneal shunt for hydrocephalus in children

作　　者：冯书彬 齐林 吕强 芦山 张耀东 

机构地区：[1]郑州儿童医院神经外科,河南郑州450018

出　　处：《中国实用神经疾病杂志》2017年第24期70-74,共5页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关计划项目;编号:201701034

摘　　要：目的探讨神经内镜下三脑室底造瘘术(ETV)与脑室-腹腔分流术(VPS)治疗患儿脑积水疗效分析。方法选择39例脑积水患儿,根据手术方式分为实验组(ETV,n=19)与对照组(VPS,n=20),术后随访6个月,并采用"Gesell儿童智力发育诊断量表"进行脑认知功能评测,包括精细运动行为和大运动行为、语言功能、适应能力及个人-社会行为,比较2组患儿手术有效率,术后感染与脑认知功能的差异。结果在手术总体有效率上,实验组94.73%,对照组85%,差异有统计学意义(P<0.05);在术后6个月内,实验组感染发生率5.26%,对照组的感染发生率25%,差异有统计学意义(P<0.01);术后实验组患儿在精细运动行为和大运动行为、语言功能、适应能力及个人-社会行为方面均优于对照组患儿,差异有统计学意义(P<0.05)。结论在治疗患儿脑积水方面,ETV在手术总体有效率,术后6个月内感染与术后脑认知功能方面均优于VPS。Objective To explore the curative effect of endoscopic three ventriculostomy （ETV） and ventriculoperitoneal shunt （VPS） in treatment of children with hydrocephalus .Methods 39 cases of children with hydrocephalus were divided into ex-perimental group （ETV ,n=19） and control group （VPS ,n=20） ,after 6 months of follow-up ,all patients received ＆quot;Gesell chil-dren＆#39;s intelligence development diagnosis scale＆quot;for evaluation of cognitive function ,including exercise behavior ,exercise behavior , fine adaptability and the function of language and personal social behavior ,the two groups were compared for the effective rate of surgery ,postoperative infection and postoperative cognitive function .Results The total effective rate in the experimental group was 94.73% and 85% in the control group with a significant difference （P〈0.05）;after 6 months operation ,the infection rate in the experimental group was 5.26% and 25% in control group with a significant difference （P〈0.01）;after surgery the move-ment ,fine motor behavior ,adaptation ability ,language function and personal social behavior in the experimental group were better than the control group ,the differences were statistically significant （P〈0.05） .Conclusion In the treatment of children with cere-bral hydrocephalus ,three ventriculostomy surgery is effective and lead to a lower infection rate and better cognitive function than those of ventriculoperitoneal shunt .

关 键 词：患儿脑积水 三脑室底造瘘术 脑室-腹腔分流术 脑认知功能 术后感染 

分 类 号：R748[医药卫生—神经病学与精神病学]