儿童急性梗阻性脑积水Ommaya储液囊植入术的护理

Nursing Practice of Ommaya Reservoir Implantation in the Treatment of Children with Acute Obstructive Hydrocephalus

目的探讨Ommaya储液囊在儿童急性梗阻性脑积水中的应用及护理。方法回顾性分析2006-2009年温州医科大学附属第二医院收治的维生素K依赖因子缺乏性脑室出血和结核性脑膜炎所致急性梗阻性脑积水患儿22例的临床资料。所有患儿均行Ommaya储液囊植入手术,术前认真评估病情,积极做好各项术前准备,术后总结并发症的观察与采取的护理措施。结果经治疗,15例脑出血伴急性梗阻性脑积水患儿无一例发生颅内感染,仅1例患儿因持续脑积水行脑室-腹腔分流手术。结核性脑膜炎伴急性梗阻性脑积水患儿中有6例经治疗脑脊液恢复正常,无复发;1例患儿治疗4个月后脑脊液常规白细胞20×106/L^40×106/L,无临床症状,取出Ommaya储液囊2个月后脑脊液复查正常。结论 Omrnaya储液囊植入术治疗儿童急性梗阻性脑积水效果良好,手术简便、创伤小、并发症少,值得临床广泛应用。

Objective To explore the application and nursing practice of Ommaya reservoir implantation in the treatment of children with acute obstructive hydrocephalus.Methods Clinical data of 22 cases of late onset lack of vitamin K dependent factor caused intraventricular hemorrhage and children with brain induced acute obstructive hydrocephalus were analyzed retrospectively. All patients were had Ommaya res- ervoir implantation with careful preoperative evaluation of the illness, well preoperative preparation, and observation and nursing measures of postoperative complications were summarized. Results None of the patient had intracranial infection after treatment,and 1 patient had ventricle peritoneal shunt because of the sustained hydrocephalus. 6 Patients with tuberculous meningitis complicated with acute obstructive hydro- cephalus were covered under the treatment of cerebrospinal fluid, with no relapse. 1 patient were had 4 months treatment with cerebrospinal fluid white blood cell 20×10 6/L-40× 10 6/L, and with no clinic symptom, the patient were convered after two months of removing the Ommaya reservoir implantation. Conclusion The effect Omrnaya reservoir implantation in the treatment of children with acute obstructive hydrocephalus was good, and the operation is simple with less trauma, less complications, and it is worthy of clinical application.