Ji Wenyuan, Liang Ping, Zhou Yudong, Li Lusheng, Zhai Xuan, Xia Zuozhong
Department of Neurosurgery, Children's Hospital Affiliated to Chongqing Medical University, Chongqing 400014, China.E-mail:
Nan Fang Yi Ke Da Xue Xue Bao. 2013 Nov;33(11):1696-8.
To explore the management of obstructive hydrocephalus caused by posterior fossa tumors before tumor resection in children.
The clinical data were reviewed of 162 pediatric patients of posterior fossa tumors with obstructive hydrocephalus undergoing surgical tumor removal between January 2008 and June 2012. Ninety children received preoperative Ommaya external drainage (group A) and 72 underwent preoperative ventriculo-peritoneal shunting (V-Ps) (group B). The therapeutic effects were evaluated and compared between the two groups.
Postoperative complications found in a total of 67 cases including infection (27), shunt blockage (19), subdural hematoma or effusion (16), ventricle fissure syndrome (5), and tumor hernia (4). Significant differences were found in the incidences of shunt blockage (P=0.047) and subdural hematoma or effusion (P=0.039) but not in the incidences of intracranial infection (P=0.478) or tumor hernia (P=0.462) between the two groups.
Ommaya reservoir can produce good results through simple surgical procedures for treatment of acute hydrocephalus in children with posterior fossa tumors and is associated less trauma and complications.
探讨儿童后颅窝肿瘤切除术前梗阻性脑积水的处理方法。
回顾性分析2008年1月至2012年6月期间162例行手术切除后颅窝肿瘤合并梗阻性脑积水的儿科患者的临床资料。90例患儿术前行Ommaya外引流（A组），72例术前行脑室-腹腔分流术（V-P分流）（B组）。对两组的治疗效果进行评估和比较。
共发现67例术后并发症，包括感染（27例）、分流管堵塞（19例）、硬膜下血肿或积液（16例）、脑室裂隙综合征（5例）和肿瘤疝（4例）。两组间分流管堵塞发生率（P=0.047）和硬膜下血肿或积液发生率（P=0.039）有显著差异，但颅内感染发生率（P=0.478）和肿瘤疝发生率（P=0.462）无显著差异。
Ommaya贮液器通过简单的手术操作可有效治疗儿童后颅窝肿瘤急性脑积水，且创伤小、并发症少。
