不同年龄阶段脑积水行脑室-腹腔分流术后并发症的临床分析

Clinical analysis on complications for hydrocephalus after ventriculo-peritoneal shunt in different ages

目的探讨不同年龄阶段脑积水患者行脑室-腹腔分流术后的主要并发症及临床处理。方法回顾性分析新疆医科大学第一附属医院神经外科收治的96例不同年龄阶段脑积水患者的临床资料。均行脑室-腹腔分流(V-P)术,随访1年。结果婴幼儿组患儿V-P术后的并发症为分流装置出现异常(分流管一端脱落或阻塞,或分流泵致皮肤破溃感染等)7例,颅内感染1例;儿童组分流管堵塞2例,颅内感染1例,腹腔端穿出口腔1例;成人组感染7例,均为开放性颅脑损伤患者,分流管阻塞2例。婴幼儿组分流装置异常的发生率与儿童组比较,感染发生率与成人组比较,差异均有统计学意义(均P<0.05)。结论不同年龄阶段脑积水患者行脑室-腹腔分流术治疗后主要的并发症不同,临床处理时要注重主要并发症的预防,针对不同年龄阶段脑积水及术后并发症应采取个体化治疗。

Objective To explore the complications and its treatment in different ages hydrocephalus patients after ventriculo-peritoneal（V-P） shunt. Methods The clinical data of 96 hydrocephalus patients in different ages treated in our department were analyzed retrospectively. All patients underwent V-P shunt. Results The infant group were most related to shunt devices （blockage of shunt tube, infection, skin ulceration caused by pump） in 7 casea, intracranial infection in 1. In children group shunt pipe was obstructed in 2 cases, intracranial infection in 1,1 distal wear a month. In adult group, intracranial infection was in 7 patients with open craniocerebral injury, shunt tube obstruction in 2. Child V-P shunt complications were infection, the incidence of abnormal consistent shunt device. Adult V-P shunt complications were infection. The differences were statisti-cally significant in the incidence of abnormalities compared with infants and children group （ P 〈 0.05 ） and the incidence of infection compared with infants and adults group（ P 〈 0.05 ）. Conclusion Complications after V-P shunt in different ages are unique, efforts should be focused on prevention of major complications, and treatment should be individualized.