VPS术与ETV术对脑积水术后婴幼儿脑室及脑认知功能的影响分析

Effects of VPS and ETV on ventricular and cerebral cognitive function of infants after hydrocephalus operation

目的探讨脑室-腹腔分流术(VPS)与神经内镜下第三脑室底造瘘术(ETV)对脑积水术后婴幼儿脑室及脑认知功能的影响。方法将我院2016年5月-2019年5月收治的93例脑积水婴幼儿按照手术方式分组,对照组46例行ETV治疗,观察组47例行VPS治疗。观察两组脑认知功能、脑室大小及术后并发症发生情况。结果观察组术后2个月末、6个月末脑认知功能评分较对照组高(P<0.05);观察组术后2个月末、6个月末脑电图异常和单光子发射计算机断层成像术(SPECT)异常比例较对照组低,脑室额角和第三脑室宽度较对照组小(P<0.05);两组患儿术后并发症发生率对比差异无统计学意义(P>0.05)。结论VPS可通过改善脑积水婴幼儿术后脑室状态,降低对脑认知功能损伤且术后并发症少。

Objective To investigate the effects of ventriculoperitoneal shunt(VPS)and endoscopic third ventriculostomy(ETV)on ventricular and cerebral cognitive functions of infants after hydrocephalus operation.Methods Ninety-three infants with hydrocephalus admitted to our hospital from May 2016 to May 2019 were divided into different groups according to surgical methods.Forty-six infants in the control group received ETV treatment,while 47 infants in the observation group received VPS treatment.The cognitive function,ventricular size and postoperative complications of two groups were observed.Results The scores of cognitive function at the end of 2 months and 6 months after operation in the observation group were higher than those in the control group(P<0.05).The abnormality rates revealed by electroencephalogram and single photon emission computed tomography(SPECT)in the observation group at the end of 2 and 6 months after operation were lower than those in the control group,and the width of ventricle frontal and the third ventricle were smaller than those in the control group(P<0.05).There was no significant difference in the incidence of postoperative complications between two groups(P>0.05).Conclusion VPS can reduce cognitive impairment and postoperative complications in infants with hydrocephalus by improving ventricular status after operation.