儿童脑积水病因与脑室-腹腔分流效果分析

目的:探讨儿童脑积水的病因及脑室-腹腔分流术治疗的效果。方法:对在我院诊治的22例儿童脑积水根据病史及CT或MR检查结果进行病因分析,行脑室-腹腔分流术治疗并随访治疗效果。结果:22例脑积水病因中原因不明12例,颅脑损伤3例(其中产伤2例,摔伤1例),颅内感染史3例,脑肿瘤2例,脑肿瘤术后1例,缺血缺氧后1例;术后随访3个月~10年,19例好转,2例因分流管梗阻无改善,再行脑室-腹腔分流手术后好转,1例术后出现慢性硬膜下血肿,经钻孔引流血肿后症状好转,无脑出血及感染等并发症。结论:儿童脑积水先天性因素多见,产伤和缺氧也占较大比例,颅内感染和先天性脑肿瘤也是导致儿童脑积水的重要因素。采用脑室-腹腔分流术治疗儿童脑积水,简单、安全、有效、并发症少,适合基层医院开展。

Etiology of 22 Children with Pediatric Hydrocephalus and Effect of Ventriculo-peritoneal Shunting

Objective:To discuss the cause of the children hydrocephalus and the clinical effect of ventriculoperitoneal shunt(V-P).Methods:To analyze the cause of 22 chilldren with hydrocephalus according to CT and MR.The clinical effect were analysised after the ventriculoperitoneal shunt.Results:Unexplained etiology of hydrocephalus in12 cases,brain injury in 3 cases(including birth trauma in 2 cases,fall wound in 1 cases),intracranial infection history in 3 cases,brain tumor in 2 cases,brain tumor after operation in 1 cases,1 cases after hypoxia ischemia.During the following-up ranging 3 months to 10 years,the clinical symptoms of 19 patients were ameliorated after operation,2 cases have no improvement due to obstruction of shunt tube,the ventriculoperitoneal shunt again.1 cases of postoperative chronic subdural hematoma,the symptom improved after trepanation and drainage operation.without intracerebral hemorrhage and infection complications.Conclusion:Congenital factors,birth trauma and hypoxia accounted for a large proportion,in the cause of children hydrocephalus,intracranial infection and congenital brain tumors are also important factors leading to hydrocephalus in children.The ventriculo-peritoneal shunt for hydrocephalus in children is simple,safe,effective,with few complications,suitable for primary hospitals.