腹腔镜下分流管约束术在儿童脑积水治疗中的应用效果研究  

Study on the Application Effect of Laparoscopic Shunt Tube Restraint in the Treatment of Hydrocephalus in Children

作　　者：卢烜 盛汉松[2] LU Xuan;SHENG Hansong(Department of Emergency Pediatrics,Children's Hospital,Guiyang Maternal and Child Health Care Hospital,Gui-yang,Guizhou,550001,China;Department of Neurosurgery,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang,325000,China)

机构地区：[1]贵阳市妇幼保健院儿童医院急诊儿科,贵州贵阳550001 [2]温州医科大学附属第二医院神经外科,浙江温州325000

出　　处：《中外医疗》2024年第25期52-55,68,共5页China & Foreign Medical Treatment

摘　　要：目的分析腹腔镜下分流管约束术在儿童脑积水治疗中的应用效果。方法随机选取2018年6月—2023年6月贵阳市妇幼保健院儿童医院收治的80例儿童脑积水患儿为研究对象,按照手术方法不同分为对照组(开腹脑室-腹腔引流术)和观察组(腹腔镜辅助下脑室-腹腔分流术),每组40例。对比两组手术相关指标、颅内血流动力学指标、神经元特异性烯醇化酶(neuron-specific enolase,NSE)、中枢神经特异性蛋白(S100 calcium binding proteinβ,S100β)水平及并发症发生率。结果观察组手术时间、颅内高压缓解时间、术后排气时间、住院时间均短于对照组,差异有统计学意义(P均<0.05)。治疗后,观察组的NSE水平为(17.25±2.26)ng/mL、S100β水平为(0.57±0.18)ng/mL,低于对照组的(26.87±2.32)ng/mL、(0.83±0.24)ng/mL,差异有统计学意义(t=18.785、5.481,P均<0.05)。治疗后,观察组大脑前动脉、大脑中动脉、大脑后动脉、双侧椎动脉血液流速均高于对照组,差异有统计学意义(P均<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论腹腔镜下分流管约束术在儿童脑积水治疗中的应用效果理想,其不仅能够优化手术相关的临床指标,还能有效缩短患儿的住院时间,降低血清中NSE、S100β水平,改善颅内血流动力学指标。Objective To analyze the application effect of laparoscopic shunt tube restraint in the treatment of hydro⁃cephalus in children.Methods A total of 80 children with hydrocephalus admitted to Children's Hospital,Guiyang Maternal and Child Health Hospital from June 2018 to June 2023 were randomly selected as the research objects.Ac⁃cording to different surgical methods,they were divided into control group(open ventricular-peritoneal drainage)and observation group(laparoscopic-assisted ventricular-peritoneal drainage),with 40 cases in each group.The operation-related indexes,intracranial hemodynamic indexes,neuron-specific enolase(NSE),S100 calcium binding proteinβ(S100β)and the incidence of complications were compared between the two groups.Results The operation time,intra⁃cranial hypertension relief time,postoperative exhaust time and hospitalization time of the observation group were shorter than those of the control group,and the differences were statistically significant(all P<0.05).After treatment,the levels of NSE and S100βin the observation group were(17.25±2.26)ng/mL and(0.57±0.18)ng/mL,which were lower than(26.87±2.32)ng/mL and(0.83±0.24)ng/mL in the control group,and the differences were statistically sig⁃nificant(t=18.785,5.481,both P<0.05).After treatment,the blood flow velocity of anterior communicating artery,middle cerebral artery,posterior cerebral artery and vertebral artery in the observation group were higher than those in the control group,and the differences were statistically significant(all P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Con⁃clusion The application effect of laparoscopic shunt tube restraint in the treatment of hydrocephalus in children is ideal.It can not only optimize the clinical indicators related to the operation,but also effectively shorten the hospital⁃ization time of the children,reduce the levels of NSE and S100βin serum,and improve the int

关 键 词：腹腔镜 分流管约束术 儿童脑积水 应用效果 

分 类 号：R4[医药卫生—临床医学]