Persson Eva-Karin, Anderson Susann, Wiklund Lars-Martin, Uvebrant Paul
Department of Paediatrics, Halmstad County Hospital, Halmstad, Sweden.
Childs Nerv Syst. 2007 Oct;23(10):1111-8. doi: 10.1007/s00381-007-0324-7. Epub 2007 Apr 12.
The purpose of this study was to monitor incidence and outcome in children with hydrocephalus.
This is a population-based prospective study of all the children with hydrocephalus born in western Sweden in 1999-2002. Etiological and clinical information was collected from records, neuroimaging and ophthalmological examinations. Comparisons with 208 children born in 1989-1998 were made.
The incidence was 0.66 per 1,000 live births, 0.48 for infantile hydrocephalus and 0.18 for hydrocephalus associated with myelomeningocele. The corresponding rates for 1989-1998 were 0.82, 0.49 and 0.33. Ventriculo-peritoneal shunt treatment was used in 42 of the 54 children and endoscopic third ventriculostomy in 12. Revisions were performed in 33 (61%). Neurological impairments were present in 63%, and they were more common in children born preterm than in those born at term. The radiological extent of parenchymal lesions correlated significantly with outcome. Ophthalmological abnormalities were found in 80%, including visual impairment in one third.
The incidence of post-haemorrhagic hydrocephalus in children born extremely preterm increased; a group running a high risk of neurological sequelae. Ophthalmological abnormalities were frequent and need to be assessed in all children with hydrocephalus. The high rate of morbidity and complications necessitates the further development of preventive and treatment methods.
本研究旨在监测脑积水患儿的发病率及预后情况。
这是一项基于人群的前瞻性研究，对象为1999年至2002年在瑞典西部出生的所有脑积水患儿。从病历、神经影像学检查和眼科检查中收集病因及临床信息，并与1989年至1998年出生的208名儿童进行比较。
发病率为每1000例活产儿中有0.66例，婴儿脑积水为0.48例，与脊髓脊膜膨出相关的脑积水为0.18例。1989年至1998年的相应发病率分别为0.82例、0.49例和0.33例。54名儿童中有42名接受了脑室-腹腔分流术治疗，12名接受了内镜下第三脑室造瘘术。33名（61%）进行了翻修手术。63%的患儿存在神经功能障碍，早产患儿比足月儿更常见。脑实质病变的放射学范围与预后显著相关。80%的患儿存在眼科异常，其中三分之一有视力障碍。
极早产儿中出血后脑积水的发病率有所增加；这组患儿有发生神经后遗症的高风险。眼科异常很常见，所有脑积水患儿都需要进行评估。高发病率和并发症率使得有必要进一步开发预防和治疗方法。
