早产儿出血后脑积水的脑脊液引流选择
Cerebrospinal fluid drainage options for posthemorrhagic hydrocephalus in premature neonates.
作者信息
Melo José Roberto Tude, Passos Rosane Klein, Carvalho Marcelo Liberato Coelho Mendes de
机构信息
Hospital Pediátrico Martagão Gesteira, Unidade de Neurocirurgia Pediátrica, Salvador BA, Brasil.
Hospital Pediátrico Martagão Gesteira, Unidade de Radiologia, Salvador BA, Brasil.
出版信息
Arq Neuropsiquiatr. 2017 Jul;75(7):433-438. doi: 10.1590/0004-282X20170060.
OBJECTIVE
The literature describes various cerebrospinal fluid (CSF) drainage techniques to alleviate posthemorrhagic hydrocephalus in preterm newborns; however, consensus has not been reached. The scope of this study was describing a case series of premature neonates with posthemorrhagic hydrocephalus and assessing the outcomes of different approaches used for CSF diversion.
METHODS
A consecutive review of the medical records of neonates with posthemorrhagic hydrocephalus treated with CSF drainage was conducted.
RESULTS
Forty premature neonates were included. Serial lumbar puncture, ventriculosubgaleal shunt, and ventriculoperitoneal shunt were the treatments of choice in 25%, 37.5% and 37.5% of the cases, respectively.
CONCLUSION
Cerebrospinal fluid diversion should be tailored to each case with preference given to temporary CSF drainage in neonates with lower age and lower birth-weight, while the permanent ventriculoperitoneal shunt should be considered in healthier, higher birth-weight neonates born closer to term.
目的
文献中描述了多种脑脊液（CSF）引流技术以缓解早产新生儿出血后脑积水；然而，尚未达成共识。本研究的范围是描述一系列出血后脑积水的早产新生儿病例，并评估用于脑脊液分流的不同方法的结果。
方法
对接受脑脊液引流治疗的出血后脑积水新生儿的病历进行连续回顾。
结果
纳入了40例早产新生儿。连续腰椎穿刺、脑室-帽状腱膜下分流术和脑室-腹腔分流术分别是25%、37.5%和37.5%病例的首选治疗方法。
结论
脑脊液分流应根据具体情况进行调整，对于年龄较小、出生体重较低的新生儿，优先考虑临时脑脊液引流，而对于更健康、出生体重较高且接近足月出生的新生儿，则应考虑永久性脑室-腹腔分流术。
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