Sainte-Rose C, Piatt J H, Renier D, Pierre-Kahn A, Hirsch J F, Hoffman H J, Humphreys R P, Hendrick E B
Service de Neurochirurgie, Hôpital des Enfants Malades, Paris, France.
Pediatr Neurosurg. 1991;17(1):2-9. doi: 10.1159/000120557.
A retrospective study was conducted on 1,719 hydrocephalic patients, treated between 1974 and 1983 at the Hospital for Sick Children (Toronto) and l'Hôpital des Enfants Malades (Paris), in order to better understand shunt failure. The statistical analysis demonstrates the following: (1) A probability of occurrence of shunt malfunction of 81% at 12 years of follow-up. (2) A high prevalence of shunt obstruction (56.1% of all malfunction) and fracture or disconnection of the tubings (13.6%). (3) A higher risk of proximal occlusion with flanged ventricular catheter. (4) Less malfunction with proximal-non-slit valves as compared to distal-slit valves. (5) The importance of pressure-flow characteristics of the shunt; because of an indirect relation between overdrainage and proximal occlusion. (6) A correlation between connectors and migration or fracture of the shunt. (7) Less distal obstructions when an open-ended distal-catheter was used. These complications were of some clinical, psychological and economical consequences. Their rate could be lowed.
对1974年至1983年间在多伦多病童医院和巴黎儿童疾病医院接受治疗的1719例脑积水患者进行了一项回顾性研究，以便更好地了解分流失败情况。统计分析结果如下：（1）随访12年时，分流装置发生故障的概率为81%。（2）分流梗阻的发生率很高（占所有故障的56.1%），以及管道的断裂或脱节（占13.6%）。（3）带凸缘的脑室导管近端闭塞的风险更高。（4）与远端有裂隙的瓣膜相比，近端无裂隙瓣膜的故障较少。（5）分流装置压力-流量特性的重要性；因为引流过度与近端闭塞之间存在间接关系。（6）连接器与分流装置的移位或断裂之间存在相关性。（7）使用开放式远端导管时远端梗阻较少。这些并发症具有一定的临床、心理和经济后果。其发生率可以降低。
