摘要
目的探讨内镜下三脑室底造瘘术在小儿梗阻性脑积水治疗中的应用效果。方法回顾性分析2000年2月至2011年8月收治的40例梗阻性脑积水患儿的临床资料,采用三脑室底造瘘术治疗的20例为观察组,采用脑室腹腔分流术治疗的20例为对照组,比较2组患儿治疗前后脑脊液压力的变化、手术时间、临床疗效、术后并发症、住院时间及再次手术率。结果观察组的总有效率(100%)与对照组的总有效率(95.0%)比较差异无统计学意义(P>0.05);2组术后近期并发症发生率及住院时间相近(P均>0.05);观察组术后远期并发症发生率及再次手术率较对照组有所降低,但差异无统计学意义(P均>0.05);观察组的手术时间显著短于对照组(P<0.05)。结论脑室腹腔分流法和脑室镜下第三脑室底造瘘术都是治疗小儿梗阻性脑积水的有效方法,但脑室镜下第三脑室底造瘘治疗时间短,是否能在降低远期并发症及复发率方面获益尚需进一步研究。
Objective To observe the efficacy of endoscopic third ventriculostomy （ETV） in the treatment of pediatric obstructive hydrocephalus. Methods Clinical data of dO cases of pediatric obstructive hydrocephalus admitted from February 2000 to August 2011 were retrospectively analyzed, Twenty cases underwent the ETV treatment were classified as observation group, and 20 cases underwent ventriculoperitoneal shunting （VPS） treatment were classified as control group. The changes of cerebrospinal fluid pressure, operative time, clinical efficacy, postoperative complications, length of hospital stay and reoperation rate were compared between two groups. Results There was no significant difference in total effective rate of observation group and control group （ 100% vs 95.0% ,P 〉 0.05）. The incidence of postoperative short-term complications and hospitalization time were similar in two groups （ all P 〉 0. 05 ）. Compared with control group, the incidence of long-term postoperative complications and reoperation rate in observation group were decreased, but there were no statistical significance difference between two groups（ all P 〉 0.05 ）. Operative time in observation group was significantly shorter than that in control group （ P 〈 0. 05）. Conclusion All VPS and ETV are effective methods for the treatment of pediatric obstructive hydrocephalus. Operative time of ETV is shorter, but it needs further research that whether it benefits in reducing longterm complications and recurrence rate.
出处
《中国临床研究》
CAS
2012年第11期1055-1056,共2页
Chinese Journal of Clinical Research
关键词
内镜下三脑室底造瘘术
脑室腹腔分流术
小儿梗阻性脑积水
Endoscopic third ventriculostomy
Ventriculoperitoneal shunting
Pediatric obstructive hydrocephalus
