手术治疗儿童脑脊液分流并发症:单中心回顾性分析

Surgical treatment of complications of cerebrospinal fluid shunting in children:A single-center retrospective analysis

目的总结需手术治疗的儿童脑脊液分流并发症的原因、手术方式及病儿预后。方法回顾性分析85例行脑脊液分流术的<16岁的病儿资料。统计病儿的年龄、性别、脑脊液循环障碍的病因等资料。对出现脑脊液分流并发症需手术干预的24位病儿的并发症类型、处理措施及预后进行分析总结,统计需外科治疗的分流并发症与病儿年龄、性别、脑脊液循环障碍的病因及分流类型的相关性。结果≤1岁的脑脊液分流病儿中有54.2%的病儿因出现分流并发症实施再次手术;脑外伤导致的脑积水病儿发生分流修正的比例最低(4.2%);先天性脑积水分流术后发生并发症需手术治疗的比例最高(41.7%)。分流管堵塞、外露及断裂是分流术后需外科处理的常见原因。结论低龄(≤1岁)是儿童脑脊液分流术后需再次手术治疗的危险因素。

Objective To summarize the causes,surgical methods,and prognosis of complications of cerebrospinal fluid(CSF)shunting requiring surgical treatment in children.Methods The clinical data of 85 children aged<16 years who underwent CSF shunt surgery were analyzed retrospectively.Patient demographics,including age,gender,and etiology of CSF circulation disorders,were recorded.Among them,24 children who developed CSF shunt complications requiring surgical intervention were further analyzed for the types of complications,treatment measures,and prognosis.The correlation between surgical complications of shunt surgery and the child's age,gender,etiology of CSF circulation disorders,and shunt type was statistically analyzed.Results Among children≤1 year old who underwent CSF shunting,54.2%required reoperation due to shunt complications.The proportion of shunt revision due to traumatic brain injury-related hydrocephalus was the lowest(4.2%),while the proportion was highest(41.7%)in children with congenital hydrocephalus.Common reasons for surgical intervention after shunting included shunt blockage,exposure,and fracture.Conclusion Young age(≤1 year old)is a risk factor for requiring reoperation after CSF shunt surgery in children.