Steinbok P, Irvine B, Cochrane D D, Irwin B J
Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Childs Nerv Syst. 1992 Mar;8(2):92-6. doi: 10.1007/BF00298448.
The long-term functional outcome of 101 children born with meningomyelocele between 1971 and 1981 was assessed, by a combination of retrospective chart review and follow-up assessments. The children had been managed at birth using a process of nonstandardized selection. Eighty-three of the 101 patients survived after a minimum follow-up of 8.6 years, for a mortality rate of 18%. Forty-four of 83 children (53%) were community ambulators, and this correlated well with the presence of intact quadriceps function. Forty-eight children (58%) attended normal school and were grade-appropriate. Sixty-two of 83 patients (75%) were socially continent of urine, and 71/83 (86%) were socially continent of stool. Hydrocephalus was present in 93 of the 101 children in the study, and 85 children were shunted. Half of the shunted children required a shunt revision in the first year of life, and thereafter the rate of revision decreased, so that after 2 years the risk of revision was approximately 10% per year.
通过回顾性病历审查和随访评估相结合的方式，对1971年至1981年间出生的101例患有脊髓脊膜膨出的儿童的长期功能结局进行了评估。这些儿童出生时采用的是非标准化的选择流程进行管理。101例患者中，83例在至少随访8.6年后存活，死亡率为18%。83名儿童中有44名（53%）能够在社区行走，这与股四头肌功能完好密切相关。48名儿童（58%）进入正常学校就读且学习成绩与年级相符。83例患者中有62例（75%）在社交场合能自主控制排尿，83例中有71例（86%）在社交场合能自主控制排便。该研究中的101名儿童中有93名患有脑积水，85名儿童接受了分流手术。一半接受分流手术的儿童在出生后第一年需要进行分流装置翻修，此后翻修率下降，因此2年后每年的翻修风险约为10%。
