Ozgural Onur, Kahilogullari Gokmen, Dogan Ihsan, Eroglu Umit, Yakar Fatih, Kilinc Mustafa Cemil, Sayaci Emre Yagiz, Unlu Mustafa Agahan
Department of Neurosurgery, Ankara University School of Medicine, Ankara,Turkey.
Turk Neurosurg. 2020;30(2):194-198. doi: 10.5137/1019-5149.JTN.26588-19.1.
To define the optimal time of shunt insertion in patients with neural tube defects and hydrocephalus.
In total, 71 patients who underwent operation for neural tube defects and hydrocephalus were retrospectively evaluated between 2012 and 2018. The first group comprised 43 patients who underwent operation at different times (in 10 days after the repair of defect), and the second group comprised 28 patients who underwent operation at the same time. Ruptured and unruptured sacs were immediately considered and operated within 72 hours.
In the first group, 43 patients underwent operation for neural tube defect after birth. Ventriculoperitoneal shunt insertion was performed 10 days after wound healing. Five (11.6%) patients were diagnosed with meningitis on follow-up. Shunt infection or meningitis was not observed on follow-up in the second group, which comprised patients who underwent operation at the same time.
The lowest complication rate existed in hydrocephalus management when shunt insertion and myelomeningocele repair procedures were performed at the same time.
确定神经管缺陷合并脑积水患者分流管置入的最佳时机。
回顾性评估2012年至2018年间71例行神经管缺陷和脑积水手术的患者。第一组包括43例在不同时间（缺损修复后10天内）接受手术的患者，第二组包括28例同时接受手术的患者。破裂和未破裂的囊在72小时内立即进行处理和手术。
第一组43例患者出生后接受神经管缺陷手术。伤口愈合10天后进行脑室腹腔分流管置入。随访中5例（11.6%）患者被诊断为脑膜炎。第二组为同时接受手术的患者，随访中未观察到分流感染或脑膜炎。
同时进行分流管置入和脊髓脊膜膨出修复手术时，脑积水治疗的并发症发生率最低。
