可调压式分流管治疗小儿脑积水翟瑄梁平夏佐中周渝冬李禄生.DOCVIP

可调压式分流管治疗小儿脑积水 翟 瑄，梁 平，夏佐中，周渝冬，李禄生 （重庆医科大学附属儿童医院神经外科，儿童发育疾病省部共建 教育部重点实验室，儿科学重庆市重点实验室， 重庆 400014） 【摘要】目的：总结可调压式分流管治疗小儿脑积水的经验，探讨其临床应用价值。方法：回顾性分析24例植入可调压式分流管治疗的不同类型脑积水患儿的病情转归。患儿均行脑室-腹腔分流术，根据术中脑脊液测压结果并结合患儿临床表现、影像学检查等因素设定调压阀开放压力的初始值，术后根据患儿临床表现的改善情况及影像学复查结果进行调压阀开放压力调整。结果：术后调压次数0～4 次，平均2.6 次。随访3～２８个月，患儿临床症状均明显缓解或消失，CT检查显示脑室均较术前缩小。术后感染２例，分流管梗阻１例。结论：可调压式分流管具有压力设定个体化的优点，在小儿脑积水治疗中疗效优于固定压力分流管，可有效避免术后分流过度和分流不足的出现。 【关键词】脑积水；脑室－腹腔分流术；儿童 Clinical application of programmable valve in treatment of hydrocephalus in children ZHAI Xuan, LIANG Ping, XIA Zuo-zhong, et al . Department of Pediatric Neurosurgery. Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory Pediatrics in Chongqing ,Chongqing 400014, China 【Abstract】Objective: To summarize and assess the programmable valve in treatment of hydrocephalus in children. Methods: 24 patients with hydrocephalus in children who underwent Ventriculo-peritoneal(V-P) shunt surgery and programmable valve were implanted in operation were retrospectively analyzed. The opening pressure were settled based on aspects such as intraoperative intraventricular pressure measurement，clinical manifestation and Imaging resultsegulator opening pressure were adjusted according to clinical improvement and review imaging results post-operation. Results: Valve pressure adjustment was required from 0 to 4 times, mean 2.6 times post-operation. All the cases were follow up 3 ~ 28 months,clinical symptoms were relieved or disappeared, and CT examination showed ventricle reduced compared with preoperative in all cases. Postoperative infection in 2 cases, shunt obstruction in 1 case. Conclusions: Programmable valve has the advantages of individual pressure setting, excessive and insufficient segregation can be effectively prevented postoperation. So it has better shunt performance than standard shunt valve in the treatment of hydrocephalus in children . 【Key Words】 hy