第三脑室底造瘘术与脑室腹腔分流术治疗婴幼儿交通性脑积水疗效比较  

Comparison of curative efficacy between endoscopic third ventriculostomy and ventriculoperitoneal shunt in the infants with communicating hydrocephalus

作　　者：张云强[1] 涂丽君 李斌[1] 周寿红 ZHANG Yun-qiang;TU Li-jun;LI Bin;ZHOU Shou-hong(Department of Neurosurgery,the First People's Hospital of Chenzhou City,Chenzhou 423000,Hunan,CHINA;Department of Electrocardiogram,the First People's Hospital of Chenzhou City,Chenzhou 423000,Hunan,CHINA;Department of Physiology,Hengyang Medical College,University of South China,Hengyang 421001,Hunan,CHINA)

机构地区：[1]郴州市第一人民医院神经外科,湖南郴州423000 [2]郴州市第一人民医院心电图室,湖南郴州423000 [3]南华大学衡阳医学院生理学教研室,湖南衡阳421001

出　　处：《海南医学》2019年第9期1130-1133,共4页Hainan Medical Journal

基　　金：湖南省郴州市第一人民医院基金(编号:DX2015)

摘　　要：目的比较神经内镜下第三脑室底造瘘术(ETV)与脑室腹腔分流术(VPS)对婴幼儿交通性脑积水的治疗效果。方法前瞻性纳入郴州市第一人民医院神经外科2015年8月至2018年8月间收治的42例婴幼儿交通性脑积水患儿,术前按完全随机方法分为第三脑室底造瘘术(造瘘组)和脑室腹腔分流术(分流组)两组,每组21例,比较两组患儿术后疗效及术后并发症等。结果造瘘组患儿的治疗总有效率为61.9%,明显低于分流组的95.2%,差异有统计学意义(P<0.05);造瘘组患儿术后出现发热和心率快8例,感染1例,脑室少量出血2例,总并发症发生率为76.2%,分流组患儿颅内出血1例,感染2例,总并发症发生率为19.0%,造瘘组术后总并发症发生率明显高于分流组,差异有统计学意义(P<0.05)。结论脑室腹腔分流术治疗婴幼儿交通性脑积水的成功率高于第三脑室底造瘘术,且术后总并发症发生率较低。Objective To compare the therapeutic effects of endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt (VPS) on communicating hydrocephalus in infants. Methods Forty-two infants with communicating hydrocephalus who admitted to Department of Neurosurgery of Chenzhou First People's Hospital from August 2015 to August 2018 were prospectively enrolled. Before operation, 21 infants underwent endoscopic third ventriculostomy (ETV group) and 21 infants underwent ventriculoperitoneal shunt (VPS group);the curative effect and complications were compared between the two groups. Results The total effective rate of children in the ETV group was 61.9%, which was significantly lower than 95.2% in the VPS group (P<0.05). There were 8 cases of fever and fast heart rate, 1 case of infection, 2 cases of small intraventricular hemorrhage, and 76.2% of the total complications in the ETV group;there were 1 case of intracranial hemorrhage, 2 cases of infection, and 19.0% of the total complications in the VPS group. There was statistically significant difference in the incidence of total complications (P<0.05). Conclusion The success rate of ventriculoperitoneal shunt in the treatment of infantile communicating hydrocephalus is higher than that of endoscopic third ventriculostomy, and the total postoperative complication rate is lower.

关 键 词：第三脑室底造瘘 脑室腹腔分流 婴幼儿 交通性脑积水 疗效 

分 类 号：R726[医药卫生—儿科]