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逆行脑室-窦分流术的手术技术是治疗脊髓脊膜膨出术后婴儿脑积水的一种选择。

Surgical technique of retrograde ventricle-sinus shunt is an option for the treatment of hydrocephalus in infants after surgical repair of myelomeningocele.

作者信息

Oliveira Matheus Fernandes de, Teixeira Manoel Jacobsen, Norremose Karen Andrade, Matushita Hamilton, Oliveira Marcelo de Lima, Shu Edson Bor Seng, Pinto Fernando Campos Gomes

机构信息

Instituto de Psiquiatria, Hospital das Clínicas, Universidade de São Paulo, Sao Paulo, SP, Brazil.

Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil.

出版信息

Arq Neuropsiquiatr. 2015 Dec;73(12):1019-25. doi: 10.1590/0004-282X20150169.

Abstract

INTRODUCTION

Treatment of hydrocephalus is accomplished primarily through a ventricular-peritoneal shunt (VPS). This study aims to describe the application of retrograde ventricle-sinus shunt (RVSS) in patients with hydrocephalus after surgical treatment of myelomeningocele.

METHOD

A prospective, randomized and controlled pilot study. We consecutively enrolled 9 patients with hydrocephalus after surgical repair of myelomeningocele from January 2010 to January 2012. These patients underwent elective RVSS or VPS. Five underwent RVSS and 4 underwent VPS. Patients were followed for one year with quarterly evaluations and application of transcranial Doppler.

RESULTS

RVSS group showed outcomes similar to those of VPS group. Doppler revealed significant improvement when comparing preoperative to postoperative period. RVSS group had significantly higher cephalic perimeter than VPS group. Neuropsychomotor development, complications and subjective outcomes did not differ between groups.

CONCLUSION

RVSS shunt is viable; it is an alternative option for the treatment of hydrocephalus.

摘要

引言

脑积水的治疗主要通过脑室-腹腔分流术(VPS)来完成。本研究旨在描述逆行脑室-静脉窦分流术(RVSS)在脊髓脊膜膨出手术治疗后脑积水患者中的应用。

方法

一项前瞻性、随机对照试验性研究。我们连续纳入了2010年1月至2012年1月期间脊髓脊膜膨出手术修复后脑积水的9例患者。这些患者接受了择期RVSS或VPS。5例行RVSS,4例行VPS。对患者进行为期一年的随访,每季度进行评估并应用经颅多普勒检查。

结果

RVSS组的结果与VPS组相似。与术前相比,多普勒检查显示术后有显著改善。RVSS组的头围明显高于VPS组。两组间神经心理运动发育、并发症及主观结果无差异。

结论

RVSS分流术是可行的;它是治疗脑积水的一种替代选择。

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