小儿脑室-腹腔分流术术后并发症分析

目的探讨脑室-腹腔分流术治疗不同原因导致的小儿脑积水的疗效和并发症。方法对行脑室-腹腔分流术的289例脑积水患儿进行病例资料分析和并发症发生率统计,对不同并发症的治疗进行疗效总结。结果289例患儿中,24例发生并发症37次,总并发症发生率为12.46%。其中转流管近端阻塞5例,远端阻塞2例,阻塞发生率为2.42%;术后感染9例(3.11%),其中3例细菌培养阳性,包括表皮葡萄球菌2例和大肠杆菌1例,6例培养阴性;硬膜下血肿1例;外伤后管断裂2例;脑室裂隙综合征3例7次发作;伤口脑脊液漏2例;泵外露3例;皮下积液2例。死亡4例(1.38%),均为感染患儿。结论若能掌握手术技巧,对并发症进行有效的预防和治疗,脑室-腹腔分流术仍是治疗小儿脑积水的最佳方法。

Analysis of postoperative complications after ventriculo-peritoneal shunt in children

Objective To analyze the curative effects and complications of ventriculo-peritoneal shunt in treating hydrocephalus caused by different diseases in children. Methods The data of 289 children with hydrocephalus who were performed ventriculo-peritoneal shunt were examined and the incidence rate of complications was analyzed. Results Thirty-seven incidences of complications occurred in 24 patients with the total incidence rate of 12.46%.There was obstruction of proximate tube in five cases,distal end in two cases,with the obstruction rate of 2.42%.Postoperative infection happened in nine cases(3.11%).Bacterial culture was positive in three cases,two of which were Staphylococcus epidermidis and Bacillus coli in the other one.Negative results were found in six patients for the bacterial culture.Subdural hematoma occured in one case,and tube break after injury in two cases.Slit ventricle syndrome broke out seven times in three cases,leakage of cerebrospinal fluid in two,exposure of pumps in three,and subcutaneous hydrops in two.Four cases(1.38%)were dead from infection. Conclusion Ventriculo-peritoneal shunt is preferred for hydrocephalus in children if the complications are well prevented and controlled.