婴幼儿脑积水脑室-腹腔分流术引流管堵塞危险因素及间充质干细胞治疗的影响

目的探讨婴幼儿脑积水行脑室-腹腔分流手术后,引起引流管堵塞的术前相关危险因素,以及术前脐带间充质干细胞(Mesenchymal stme cells,MSC)治疗对并发症发生率的影响。方法回顾性分析125例婴幼儿行脑积水分流术后2年内,并发术后分流管堵塞的各种危险因素;同时,分析11例术前接受静脉输注MSC治疗的患儿危险因素水平减低程度及引流管堵塞的发生情况。结果分流术后引流管堵塞的客观危险因素按相关性排序,依次为:术前脑脊液细胞总数、术前脑脊液蛋白含量、月龄、引流管末端位置和术前血白蛋白指标;MSC治疗后血清白蛋白水平显著升高,术前进行干细胞治疗组引流管阻塞发生率为1/11,显著低于未治疗组(53/114)(P<0.01)。结论术前输注MSC可提高血清白蛋白水平,减少手术后并发症的发生。

The Risk Factors of Ventriculo-peritoneal Shunt Tube Blockage in Infantile Hydrocephalus and the Effect of Mesenchymal Stem Cell Therapy Prior to Surgery

Objective To investigate the risk factors of ventriculo - peritoneal shunt tube blockage after surgery in infant with hydrocephalus and the effect of preoperative administration of umbilical cord mesenchymal stem cells （Mesenchymal stme cells, MSC） on the incidence of this complication. Methods A retrospective analysis was conducted in 125 cases of infant with hydrocephalus to evaluate the occurrence of shunt blockage during the follow-up of 2 years after ventriculo- peritoneal drainage. Further, the incidence and its associated factors in 11 cases who received intravenous infusion of MSC treatment preoperatively were also analyzed. Results The clinical risk factors included preoperative cerebrospinal fluid cell count, cerebrospinal fluid protein content, age, terminal of location drainage tube and serum albumin concentrations orderly. MSC treatment significantly increased serum albumin level and decreased the occurrence of drainage tube obstruction （1/11 vs. 53/114, P〈0.01）. Conclusion Preoperative infusion of MSC can increase the level of serum albumin and reduce post- operative complications.