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既往已行分流术儿童的内镜下第三脑室造瘘术:一项回顾性研究

Endoscopic third ventriculostomy in previously shunted children: a retrospective study.

作者信息

Marton Elisabetta, Feletti Alberto, Basaldella Luca, Longatti Pierluigi

机构信息

Department of Neurosurgery, Treviso Hospital, University of Padova, Piazzale Ospedale 1, Treviso, Italy.

出版信息

Childs Nerv Syst. 2010 Jul;26(7):937-43. doi: 10.1007/s00381-010-1130-1. Epub 2010 Mar 30.

Abstract

PURPOSE

The aim of this study was to assess the mid-term results, success rates, and time-to-failure of secondary endoscopic third ventriculostomy (secondary ETV), as well as the complex management of preoperative and postoperative cares.

METHODS

To this purpose, a retrospective analysis of a pediatric population of 22 children who underwent endoscopic third ventriculostomy (ETV) after shunt malfunction (secondary ETV) was performed.

RESULTS

The failure rate, given by the percentage of new shunt replacement in the first 3 months after ETV, was 36%, with a mean time to failure of 14.3 days. All the failures were evident within 1 month after the ETV. Despite the small number of patients in our series, we found no significant correlation between ETV failure and both patient age and hydrocephalus etiology (p = 0.47 and p = 0.78, respectively).

CONCLUSIONS

In our experience, ETV secondary to shunt malfunction in pediatric patients has a success rate of 64%. As it is a safe and rapid treatment option even in emergency conditions, it is worth performing this procedure in previously shunted children.

摘要

目的

本研究旨在评估二期内镜下第三脑室造瘘术(二期ETV)的中期结果、成功率和失败时间,以及术前和术后护理的综合管理。

方法

为此,对22例因分流器故障而接受内镜下第三脑室造瘘术(ETV)的儿童患者进行了回顾性分析(二期ETV)。

结果

以ETV术后前3个月内新更换分流器的百分比计算,失败率为36%,平均失败时间为14.3天。所有失败均在ETV术后1个月内显现。尽管我们系列中的患者数量较少,但我们发现ETV失败与患者年龄和脑积水病因均无显著相关性(分别为p = 0.47和p = 0.78)。

结论

根据我们的经验,小儿患者分流器故障继发的ETV成功率为64%。由于即使在紧急情况下它也是一种安全且快速的治疗选择,因此对先前已行分流术的儿童进行此手术是值得的。

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