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内镜下第三脑室造瘘术治疗非交通性脑积水:53例儿童短系列报告

Endoscopic Third Ventriculostomy in Noncommunicating Hydrocephalus: Report on a Short Series of 53 Children.

作者信息

Sarmast Arif, Khursheed Nayil, Ramzan Altaf, Shaheen Feroz, Wani Abrar, Singh Sarbjit, Ali Zulfikar, Dar Bashir

机构信息

Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.

Department of Radiodiagnosis, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.

出版信息

Asian J Neurosurg. 2019 Jan-Mar;14(1):35-40. doi: 10.4103/ajns.AJNS_187_16.

Abstract

INTRODUCTION

Endoscopoic third ventriculostomy (ETV) is currently considered the best alternative to cerebrospinal fluid (CSF) shunt systems in the treatment of obstructive hydrocephalus. The aim of ETV is to communicate the third ventricle with the interpendicular cistern and create CSF flow which bypasses an obstruction to the circulation of the CSF.

AIMS AND OBJECTIVES

The purpose of this study was to elucidate the indications, efficacy, safety and outcome Of ETV pediatric patients of noncommunicating hydrocephalus.

MATERIAL AND METHODS

This study is a 3 year prospective study from June 2012 to May 2015. Records were kept for age, gender, etilogical factors, symptoms, signs, previous use of shunt or external ventricular device, imaging findings, and surgical complications (intraoperative and postoperative). Only those patients with age between 6months and 18 years with symptoms of intracranial hypertension and radiographic evidence of noncommunicating hydrocephalus were included in the study.

RESULTS

A total of 53 patients were studied, out of these 29 were boys and 24 were girls. The mean age of the patients was 6.6 years. Overall a total of 50 successful ETVs were done in 53 patients. The success rate is estimated to be 94%. There was no mortality. The average postoperative hospital stay was 4 days. The followup ranged from 6 to 16 months (mean, 12 months).

CONCLUSION

ETV in children is a safe, simple and effective treatment and a logical alternative to shunting procedure for patients of noncommunicating hydrocephalus.

摘要

引言

内镜下第三脑室造瘘术(ETV)目前被认为是治疗梗阻性脑积水时脑脊液(CSF)分流系统的最佳替代方法。ETV的目的是使第三脑室与脚间池相通,并建立脑脊液流动,绕过脑脊液循环的梗阻部位。

目的

本研究的目的是阐明ETV治疗小儿非交通性脑积水的适应证、疗效、安全性及结果。

材料与方法

本研究是一项从2012年6月至2015年5月的为期3年的前瞻性研究。记录患者的年龄、性别、病因、症状、体征、既往是否使用过分流器或外置脑室引流装置、影像学检查结果以及手术并发症(术中及术后)。本研究仅纳入年龄在6个月至18岁之间、有颅内高压症状且有非交通性脑积水影像学证据的患者。

结果

共研究了53例患者,其中29例为男性,24例为女性。患者的平均年龄为6.6岁。53例患者中总共成功进行了50例ETV手术。成功率估计为94%。无死亡病例。术后平均住院时间为4天。随访时间为6至16个月(平均12个月)。

结论

对于小儿非交通性脑积水患者,ETV是一种安全、简单且有效的治疗方法,是分流手术的合理替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9028/6417306/e3e94c1c55a3/AJNS-14-35-g001.jpg

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