Sibanda E N, Levy L F, Makarawo S
Cent Afr J Med. 1991 Dec;37(12):397-403.
Case files of 92 patients who had their hydrocephalus relieved by the insertion of the Harare Valve shunt system were reviewed. All patients had undergone surgery for shunt insertion at the Harare Central and Parirenyatwa Teaching Hospitals in Harare, Zimbabwe, between January 1986 and January 1988. All but one patient reviewed had Harare valve ventriculoperitoneal shunt insertions. The commonest indication for shunt insertion was congenital hydrocephalus alone or coexisting with other abnormalities (62 pc). Post meningitic hydrocephalus and hydrocephalus associated with intracranial tumours were next in frequency at 26 pc and 9 pc respectively. The etiology of hydrocephalus was not diagnosed in one four-year-old patient. The ages of the patients on admission ranged from one day to seven years (mean 12.4 months). Infection rates correlated well with the etiology of hydrocephalus; lowest (2 and half pc) in patients with simple congenital hydrocephalus and highest (29.2 pc) in post meningitic patients. A variety of organisms were isolated from CSF, blood, wounds and catheter tips. Lactose fermenting coliforms, S. epidermidis and E. coli predominated. Infection was combated by antibiotics, shunt removal or a combination of both. The antibiotics most commonly used were the penicillins, chloramphenicol, cloxacillin and gentamycin.
回顾了92例通过植入哈拉雷瓣膜分流系统缓解脑积水的患者的病历。所有患者均于1986年1月至1988年1月期间在津巴布韦哈拉雷的哈拉雷中心医院和帕里伦亚瓦教学医院接受了分流植入手术。除1例接受回顾的患者外，其余所有患者均植入了哈拉雷瓣膜脑室腹腔分流管。分流植入最常见的指征是单纯先天性脑积水或与其他异常并存（62%）。脑膜炎后脑积水和与颅内肿瘤相关的脑积水的发生率次之，分别为26%和9%。1例4岁患者的脑积水病因未确诊。入院时患者年龄从1天至7岁不等（平均12.4个月）。感染率与脑积水的病因密切相关；单纯先天性脑积水患者的感染率最低（2.5%），脑膜炎后患者的感染率最高（29.2%）。从脑脊液、血液、伤口和导管尖端分离出了多种微生物。乳糖发酵大肠菌群、表皮葡萄球菌和大肠杆菌占主导地位。通过使用抗生素、移除分流管或两者结合来对抗感染。最常用的抗生素是青霉素、氯霉素、氯唑西林和庆大霉素。
