不同手术路径脑室-腹腔分流术对小儿脑积水的临床疗效分析

目的比较经侧脑室额角穿刺和经侧脑室枕角穿刺行脑室-腹腔分流术对小儿脑积水的临床疗效。方法回顾性分析徐州医科大学附属医院2014年5月至2018年6月收治的58例诊断为脑积水并行脑室-腹腔分流术患儿的临床资料,根据手术路径不同分为额角穿刺组(32例)和枕角穿刺组(26例)。比较2组患儿术后常见并发症的发生情况;术后随访1年,按照格拉斯哥昏迷评分(GCS)评价手术疗效。结果与枕角穿刺组相比,额角穿刺组术后并发症较少,堵管发生率较低,差异有统计学意义(P<0.05)。术后1年,2组患儿GCS评分明显高于术前,差异具有统计学意义(P<0.05)。结论与经侧脑室枕角穿刺比较,经侧脑室额角穿刺路径的脑室-腹腔分流术可降低相关术后并发症的发生率,其临床疗效优于经枕角穿刺的分流术式。

Clinical effect analysis of ventriculoperitoneal shunt with different surgical approaches on hydrocephalus in children

Objective To compare the clinical effects of ventriculoperitoneal shunt with front horn puncture and occipital horn puncture in the treatment of hydrocephalus in children.Methods The clinical data of 58 children with hydrocephalus treated in the affiliated hospital of Xuzhou medical university from May 2014 to June 2018 were analyzed retrospectively.According to the different surgical approaches,the patients were divided into the front horn puncture group(n=32)and the occipital horn puncture group(n=26).The incidence of common postoperative complications in the two groups were compared,and the postoperative follow-up was conducted for 1 year to evaluate the surgical effect of the patients according to the Glasgow coma scale(GCS).Results The postoperative complications and the incidence of tube occlusion in the front horn puncture group were significantly lower than those in the occipital horn puncture group,and the differences were significant(P<0.05).After followed-up for 1 year,the GCS scores after operation in the two groups were significantly higher than those before operation(P<0.05).Conclusion Compared with the occipital horn puncture of lateral ventricle,the shunt through front horn puncture can reduce the incidence of related postoperative complications,and its clinical effect may be better than that of occipital horn puncture.