Mwachaka Philip M, Obonyo Nchafatso G, Mutiso Ben K, Ranketi Simeon, Mwang'ombe Nimrod
Department of Surgery, University of Nairobi, Nairobi, Kenya.
Pediatr Neurosurg. 2010;46(1):1-5. doi: 10.1159/000314050. Epub 2010 May 5.
BACKGROUND/AIMS: Ventriculoperitoneal shunt complications have scarcely been reported in sub-Saharan Africa. This study aimed at determining the frequency of these complications and their associated risk factors in a Kenyan National Teaching and Referral Hospital.
This cross-sectional study retrospectively covered 117 patients admitted to the Kenyatta National Hospital neurosurgical ward between January 2005 and December 2007 with ventriculoperitoneal shunt complications. The data obtained were analysed using the Statistical Package for the Social Sciences.
The most common complication was obstruction in 63 patients (53.8%), followed by migration in 25 (21.4%) and infection in 23 (19.7%) of the patients. Up to 49.6% of the complications occurred in patients younger than 6 months. Multiple complications were seen in 23.9% of the cases. The mean shunt duration was 18.05 months. Positive correlations existed between the presence of a shunt complication and patient age, shunt duration and the number of complications developed. These correlations were, however, neither strong nor statistically significant.
This study reports the highest frequencies of shunt obstruction and migration ever recorded in the literature. The high rate of development of multiple shunt failures coupled with a short shunt duration calls for a closer monitoring of patients with ventriculoperitoneal shunts.
背景/目的：撒哈拉以南非洲地区很少有关于脑室腹腔分流术并发症的报道。本研究旨在确定肯尼亚一家国家教学和转诊医院中这些并发症的发生率及其相关危险因素。
这项横断面研究回顾性纳入了2005年1月至2007年12月期间入住肯雅塔国家医院神经外科病房的117例患有脑室腹腔分流术并发症的患者。使用社会科学统计软件包对获得的数据进行分析。
最常见的并发症是梗阻，有63例患者（53.8%）出现，其次是移位，有25例（21.4%），感染有23例（19.7%）。高达49.6%的并发症发生在6个月以下的患者中。23.9%的病例出现了多种并发症。分流管的平均使用时长为18.05个月。分流术并发症的出现与患者年龄、分流管使用时长以及出现的并发症数量之间存在正相关。然而这些相关性既不强烈也无统计学意义。
本研究报告了文献中记录的最高的分流管梗阻和移位发生率。多种分流管故障的高发生率以及较短的分流管使用时长，要求对脑室腹腔分流术患者进行更密切的监测。
