儿童脑室-腹腔分流管腹腔端断裂1例报告并文献复习

Management of broken ventriculo-peritoneal shunt catheter in children:a case report and review of literature

目的探讨脑积水脑室-腹腔分流术(VPS)后分流管腹腔端断裂的原因及诊断、治疗方式。方法回顾性分析1例脑积水行脑室-腹腔分流术后分流管腹腔端断裂患者的临床资料;并对相关文献进行复习。结果本例患者男性,12岁,脑室-腹腔分流术后10个月出现记忆力减退、行走不稳,腹部CT检查示分流管腹腔端断裂。未取出原有分流管,再次行脑室-腹腔分流术;术后患者的症状缓解,复查CT示脑室缩小。结论脑室-腹腔分流管术后腹腔端断裂是较少见的并发症,可能导致严重后果。断裂的原因与生长发育、管路老化、放置位置有关;查体及影像学检查是可靠的确诊手段,再次行脑室-腹腔分流术是有效的治疗方法。

Objective To explore the cause,diagnosis,and feasible treatment strategy for broken ventriculoperitoneal shunt(VPS)catheter in children hydrocephalus.Methods The clinical data of a child with postoperative VPS break was analyzed retrospectively and the related literature were reviewed.Results This 12-years-old male child,who presented memory loss and walking instability 10 months after VPS,had a ruptured ventral part of the shunt catheter showed by abdominal CT scan.The original shunt catheter was not removed,and another VPS was performed.After operation,the patient’s symptoms were relieved,and review CT scan showed shrunken lateral ventricles.Conclusions The incidence of VPS catheter break is very low,although it is a serious complication.Many factors cause the shunt break,including growth,catheter degradation,and site of abdomen entrance.Physical examination and medical imaging examinations are reliable measurements.Another VPS surgery can be a feasible treatment.