Roberts J P, Burge D M
Wessex Regional Centre for Paediatric Surgery, Southampton, U.K.
Z Kinderchir. 1989 Dec;44 Suppl 1:32-4. doi: 10.1055/s-2008-1043289.
31 patients underwent ventricular shunting (17 VA and 14 VP) for post-haemorrhagic hydrocephalus over 11 years. The mean gestational age was 31.8 +/- 4.17 (1 SD) weeks and birth weight 1.83 +/- 0.77 (1 SD) kg, with no differences between the VA and VP groups. Shunts inserted less than 5 weeks of age failed more frequently than those inserted after 5 weeks. There were 5 early (less than 30 days) blocks all in VP shunts (p = 0.023) but no difference in distal catheter blockage rate (p = 0.14). There were no early infections. In later follow-up, 35% of patients had block episodes and 22% infective episodes with no significant difference between the type of shunt used. Overall mortality was 6.5% and not related to shunt complications. Revisions were more frequent in VP shunts (0.9 revisions/shunt year) than VA shunts (0.6 revs/shunt year). Using life table analysis 60% of VP and 30% of VA shunts failed within 2 years of insertion.
在11年期间,31例患者因出血后脑积水接受了脑室分流术(17例为脑室-心房分流术,14例为脑室-腹腔分流术)。平均胎龄为31.8±4.17(1标准差)周,出生体重为1.83±0.77(1标准差)kg,脑室-心房分流术组和脑室-腹腔分流术组之间无差异。出生后5周内插入的分流管比5周后插入的分流管失败频率更高。有5例早期(少于30天)堵塞,均发生在脑室-腹腔分流管(p = 0.023),但远端导管堵塞率无差异(p = 0.14)。无早期感染。在后期随访中,35%的患者出现堵塞事件,22%的患者出现感染事件,所用分流管类型之间无显著差异。总体死亡率为6.5%,与分流并发症无关。脑室-腹腔分流术的翻修频率(0.9次翻修/分流管年)高于脑室-心房分流术(0.6次翻修/分流管年)。使用生命表分析,60%的脑室-腹腔分流管和30%的脑室-心房分流管在插入后2年内失败。