儿童复杂性脑积水的诊断与治疗策略  

Diagnosis and treatment strategies for complex hydrocephalus in children

作　　者：鄢林[1] 姜诚 欧阳倩 廖新斌[2,3] 张治平[2,3] 肖格磊[2,3] YAN Lin;JIANG Cheng;OUYANG Qian;LIAO Xinbin;ZHANG Zhiping;XIAO Gelei(Department of Neurosurgery,Brain Hospital of Hunan Province(The Second People’s Hospital of Hunan Province),Changsha,Hunan 410007,China;Department of Neurosurgery,Xiangya Hospital of Central South University,Changsha,Hunan 410008,China;Diagnosis and Treatment Center for Hydrocephalus,Xiangya Hospital of Central South University,Changsha,Hunan 410008,China;Department of Neurosurgery,Affiliated Zhuzhou Hospital,Xiangya Medical College,Central South University,Zhuzhou,Hunan 412000,China)

机构地区：[1]湖南省脑科医院(湖南省第二人民医院)神经外科,湖南长沙410007 [2]中南大学湘雅医院神经外科,湖南长沙410008 [3]中南大学湘雅医院脑积水诊疗中心,湖南长沙410008 [4]中南大学湘雅医学院附属株洲医院神经外科,湖南株洲412000

出　　处：《国际神经病学神经外科学杂志》2024年第5期91-97,共7页Journal of International Neurology and Neurosurgery

基　　金：国家自然科学基金委员会面上项目(82171347);国家自然科学基金委员会面上项目(82371362);湖南省自然科学基金面上项目(2022JJ30971)。

摘　　要：目的研究儿童复杂性脑积水的诊断标准以及有效的治疗策略。方法回顾性分析2014年—2024年中南大学湘雅医院收治的266例复杂性脑积水患者的病历资料,分析患者的临床资料,统计患者的年龄、性别、是否存在感染、是否具有多房结构、手术次数以及最终治疗效果,并总结治疗策略。结果266例复杂性脑积水患者中,男性169例,女性97例。其中,165例患者存在感染,130例患者存在多房结构;手术次数为1至6次不等;治愈例数240例,治愈率为240/266=90.2%。结论复杂性脑积水如果早期明确诊断,进行积极治疗,可以取得较好的诊疗效果。感染是形成复杂性脑积水最重要的原因,也是处理复杂性脑积水过程中的关键要素,控制感染是治疗成功的重要环节。复杂性脑积水需要多次手术,但是手术方式无优劣之分,尽可能选择简单的手术解决问题。Objective To investigate the diagnostic criteria and effective treatment strategies for complex hydrocephalus in children.Methods A retrospective analysis was performed for the clinical data of 266 children with complex hydrocephalus who were admitted to Xiangya Hospital of Central South University from 2014 to 2024.A statistical analysis was performed for age,sex,presence or absence of infection,presence or absence of multilocular structures,number of operations,and final treatment outcomes,and treatment strategies were summarized.Results Among the 266 patients with complex hydrocephalus,there were 169 boys and 97 girls.Of all patients,165 had infection and 130 had multilocular structures,with 1-6 times of surgery,and 240 patients were cured,resulting in a cure rate of 90.2%(240/266).Conclusion Early diagnosis and active treatment can help to achieve a good treatment outcome of complex hydrocephalus.Infection is the most important cause of complex hydrocephalus and is also a key factor in the treatment process of complex hydrocephalus;therefore,controlling infection is an important step in achieving successful treatment.Complex hydrocephalus requires multiple surgeries,but there is no difference between the methods used,and simple surgical procedures should be selected as far as possible.

关 键 词：脑积水 复杂性脑积水 治疗策略 脑室外引流术 脑室-腹腔分流术 

分 类 号：R742.7[医药卫生—神经病学与精神病学]