手术治疗小儿梗阻性脑积水的疗效分析.docVIP

手术治疗小儿梗阻性脑积水的疗效分析 摘要：目的：分析不同手术方法治疗小儿梗阻性脑积水的临床疗效。方法：选取小儿梗阻性脑积水患者140例，根据手术方法将其分为观察组（77例）与对照组（63例）。观察组采用神经内镜三脑室底造瘘术（ETV）治疗，对照组采用脑室-腹腔分流术（V-P）治疗。观察两组患者的临床疗效与并发症。结果：观察组治疗有效率为81.82%，对照组为82.54%，无显著差异（P 0.05）。观察组术后不良反应发生率明显低于对照组（P 0.05）。结论：ETV与V-P治疗小儿梗阻性脑积水均有显著的临床效果，但是ETV不良反应发生率明显低于V-P。 关键词：神经内镜第三脑室底造瘘术；脑室-腹腔分流术；小儿梗阻性脑积水 Abstract：Objective： To analyze the clinical effects of different surgical treatment on pediatric obstructive hydrocephalus. Methods： 140 cases of pediatric obstructive hydrocephalus patients were chose and divided into the observation group （77 cases） and the control group （63 cases） according to the different operation method. The patients in the observation group were treated using neural endoscopic third ventricle colostomy （ETV） treatment. The patients in the control group were treated by the ventricles - peritoneal shunt （V-P） treatment. The clinical efficacy of two groups of patients and the complications were compared. Results： The treatment effective rate of the observation group is 81.82%， and the control group was 82.54%. There was no significant difference （P 0.05）. The incidence of postoperative adverse reaction in the observation group was obviously lower than the control group （P 0.05）. Conclusion： The clinical effect of pediatric obstructive hydrocephalus treated by ETV and V-P were all obvious. But the incidence of adverse reaction after treated by ETV was significantly lower than that in V-P treatment. Keywords： Neural endoscopic third ventricle colostomy （ETV）； ventricles - peritoneal shunt （V-P）； pediatric obstructive hydrocephalus 梗阻性脑积水即非交通性脑积水，由脑室系统梗阻引起脑脊液循环不畅，好发于第四脑室开口、中脑和小脑幕等位置[1]。大多数梗阻性脑积水患儿均需要通过手术进行治疗，临床上常用手术方式为Torkildsen术式及第三脑室造瘘术，前者主要应用于成人，而后者则主要应用于幼儿患者。较传统的分流术在治疗小儿梗阻性脑积水中也发挥巨大作用，但有文献曾提出，分流术中涉及的感染或机械问题等均感染患者的正常治疗效果。在本次研究中，选取在我院接受治疗的小儿梗阻性脑积水患者140例，分析并探讨不同手术方法治疗小儿梗阻性脑积水的临床疗效。 1 资料与方法 1.1样本资料 选取2010年1月-2014年7月在我院接受治疗的小儿梗阻性脑积水患者140例。男94例，女46例，年龄1岁-14岁，平均年龄（4.74±2.41）岁，头围38cm-61cm，平均头围（48.21±11.24）cm。所有患儿均表现为头围异常增大，且经影像学检查发现，所有患儿均