Agarwal Nitin, Shukla Ram Mohan, Agarwal Deepika, Gupta Kaustubh, Luthra Rohtash, Gupta Jalaj, Jain Sunny
Department of Pediatric Surgery, R.D. Gardi Medical College, Ujjain, Madhya Pradesh, India.
Department of Anesthesiology, R.D. Gardi Medical College, Ujjain, Madhya Pradesh, India.
J Indian Assoc Pediatr Surg. 2017 Jul-Sep;22(3):155-157. doi: 10.4103/0971-9261.207624.
Ventriculoperitoneal (VP) shunt is the most commonly utilized shunting procedure because of the capacity of the peritoneum to resorb fluid. Initial and subsequent peritoneal catheter placements can be done with relative ease. They are associated with a variety of complications.
The total number of patients operated in the study period was 96. We studied 41 operated patients of VP shunt who had various shunt-related complications and analyzed the predisposing risk factors and spectrum of complications.
The mean age was 28 ± 32 months out of which 28 were males and 13 females. The etiology of hydrocephalus was aqueductal stenosis in 18, Arnold Chiari malformation in 10, Dandy-Walker malformation in 2, postmeningitis in 8 (pyogenic in 5 and tubercular in 3), postintraventricular hemorrhage in 2 patients and postencephalocele surgery in 1.
With this retrospective review of complications of VP shunts, age at initial shunt insertion and the interval between the age of initial shunt placement and onset of complications were the most important patient-related predictors of shunt failure. The different predominant etiological factors responsible for early and late shunt failure were infective and mechanical complications, respectively.
由于腹膜具有吸收液体的能力,脑室腹腔(VP)分流术是最常用的分流手术。初次及后续的腹膜导管置入操作相对容易。但该手术会引发多种并发症。
研究期间接受手术的患者总数为96例。我们对41例接受VP分流术且出现各种分流相关并发症的患者进行了研究,并分析了诱发风险因素及并发症范围。
平均年龄为28±32个月,其中男性28例,女性13例。脑积水的病因包括导水管狭窄18例、阿诺德·奇亚里畸形10例、丹迪-沃克畸形2例、脑膜炎后8例(化脓性5例,结核性3例)、脑室内出血后2例以及脑膨出手术后1例。
通过对VP分流术并发症的此次回顾性研究,初次分流置入时的年龄以及初次分流置入年龄与并发症发生之间的间隔时间是与患者相关的分流失败最重要预测因素。导致早期和晚期分流失败的不同主要病因分别是感染性和机械性并发症。