1岁以下婴儿的第三脑室造瘘术。
Third ventriculostomy in infants younger than 1 year old.
作者信息
Costa Val José Aloysio, Scaldaferri Paulo Mallard, Furtado Leopoldo Mandic, de Souza Baptista Guilherme
机构信息
Pediatric Neurosurgery Department, Biocor Instituto, Nova Lima, MG, Brazil.
出版信息
Childs Nerv Syst. 2012 Aug;28(8):1233-5. doi: 10.1007/s00381-012-1740-x. Epub 2012 Jun 29.
INTRODUCTION
Endoscopic third ventriculostomy (ETV) gains more attention each day in the treatment of hydrocephalus. Some authors have questioned the effectiveness of the procedure for the treatment of infants younger than 1 year. More recent studies revealed that the effectiveness of the procedure is more related to the etiology of the disease than to the age of the patient.
MATERIALS AND METHODS
We studied retrospectively the effectiveness of third ventriculostomy in our service: 75 endoscopic procedures, from which 48 were ETVs. Among the ETVs, 30 were used to treat aqueductal stenosis, three for Dandy-Walker, eight for Chiari type II.
RESULTS
When the patients were stratified by the etiology of the hydrocephalus, there was a statistically significant difference among the groups studied with higher success among patients with aqueductal stenosis the (90 %) and lower for the treatment of Chiari II-related hydrocephalus (50 % of success). With the patients stratified by age groups, there was no significant difference in terms of the success of the treatment.
CONCLUSION
Our results have shown that the effectiveness of ETV is not actually age-related, but etiology-related.
引言
内镜下第三脑室造瘘术（ETV）在脑积水治疗中日益受到关注。一些作者对该手术治疗1岁以下婴儿的有效性提出质疑。最近的研究表明，该手术的有效性更多地与疾病的病因有关，而非患者的年龄。
材料与方法
我们回顾性研究了我院第三脑室造瘘术的有效性：75例内镜手术，其中48例为ETV。在这些ETV中，30例用于治疗导水管狭窄，3例用于治疗Dandy-Walker畸形，8例用于治疗Chiari II型畸形。
结果
当根据脑积水的病因对患者进行分层时，所研究的组间存在统计学显著差异，导水管狭窄患者的成功率较高（90%），而Chiari II型相关脑积水的治疗成功率较低（50%）。当按年龄组对患者进行分层时，治疗成功率无显著差异。
结论
我们的结果表明，ETV的有效性实际上与年龄无关，而与病因有关。
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