神经内镜下第三脑室造瘘治疗儿童梗阻性脑积水对患儿神经功能的影响

Neuroendoscopic Third Ventriculostomy for Obstructive Hydrocephalus in Children

【目的】探讨神经内镜下第三脑室造瘘治疗儿童梗阻性脑积水的疗效。【方法】回顾性分析2014年1月至2017年6月本院收治的64例梗阻性脑积水患儿临床资料,根据治疗方法的不同将其分为观察组(n=33,神经内镜下第三脑室造瘘治疗)和对照组(n=31,脑室-腹腔分流术)。比较两组临床疗效、手术相关指标,治疗前后发育商评分,并分析两组术后并发症发生情况。【结果】观察组手术时间、住院时间明显低于对照组,差异有统计学意义(P<0.05)。观察组临床有效率为93.94%(31/33)明显优于对照组的80.65%(25/31),差异有统计学意义(χ2=-2.097,P<0.05)。两组治疗后发育商明显优于治疗前,观察组明显高于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率为9.09%,低于对照组的32.26%。差异有统计学意义(χ2=5.300,P=0.021<0.05)。【结论】儿童梗阻性脑积水应用神经内镜下第三脑室造瘘治疗有较好的临床效果,有利于患儿神经功能恢复。

【Objective】To explore the effect of endoscopic third ventriculostomy in the treatment of obstructive hydrocephalus in children.【Methods】The clinical data of 64 children with obstructive hydrocephalus admitted to our hospital from January 2014 to June 2017 were analyzed retrospectively.According to different treatment methods,they were divided into observation group(n=33,endoscopic third ventriculostomy)and control group(n=31,ventriculoperitoneal shunt).The clinical effect,operation related indexes,developmental quotient scores before and after treatment were compared between the two groups,and the postoperative complications were analyzed.【Results】The operation time and hospitalization time in the observation group were significantly lower than those in the control group(P<0.05).The clinical effective rate of the observation group was 93.94%(31/33),which was significantly higher than that of the control group(80.65%)(25/31).The difference was statistically significant(χ2=-2.097,P<0.05).The difference between the two groups was statistically significant(P<0.05).The incidence of postoperative complications in the observation group was 9.09%,lower than 32.26%in the control group.The difference was statistically significant(χ2=5.300,P=0.021<0.05).【Conclusion】The application of endoscopic third ventriculostomy in the treatment of obstructive hydrocephalus in children has a good clinical effect,which is conducive to the recovery of children's neurological function.