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早产儿脑室内出血的临时手术治疗

Temporary Surgical Management of Intraventricular Hemorrhage in Premature Infants.

作者信息

Park Eun-Kyung, Kim Ja-Yoon, Kim Dong-Seok, Shim Kyu-Won

机构信息

Department of Pediatric Neurosurgery, Severance Children's Hospital, College of Medicine, Yonsei University, Seoul, Korea.

Department of Otorhinolaryngology, College of Medicine, Yonsei University, Seoul, Korea.

出版信息

J Korean Neurosurg Soc. 2023 May;66(3):274-280. doi: 10.3340/jkns.2022.0265. Epub 2023 Mar 30.

Abstract

Post-hemorrhagic hydrocephalus (PHH) in preterm infant is common, life-threatening and the main cause of bad developmental outcomes. Ventriculoperitoneal (VP) shunt is used as the ultimate treatment for PHH. Low birth weight and low gestational age are the combination of worse prognostic factors while the single most important prognostic factor of VP shunting is age. Aggressive and early intervention have better effect in intraventricular hemorrhage and intracranial pressures control. It reduces infection rate and brain damage resulted in delayed shunt insertion. It is extremely important to let PHH infants get older and gain weight to have internal organs to be matured before undergoing VP shunt. As premature infants undergo shunt after further growth, shunt-related complications would be reduced. So temporary surgical intervention is critical for PHH infants to have them enough time until permanently shunted.

摘要

早产儿出血后脑积水(PHH)很常见,会危及生命,是发育不良结局的主要原因。脑室腹腔(VP)分流术是PHH的最终治疗方法。低出生体重和低胎龄是预后较差的综合因素,而VP分流术最重要的单一预后因素是年龄。积极早期干预对控制脑室内出血和颅内压有更好的效果。它可降低感染率和因延迟插入分流管导致的脑损伤。让PHH婴儿在接受VP分流术前长大并增重,使内脏成熟极为重要。随着早产儿进一步生长后再进行分流,与分流相关的并发症将会减少。因此,临时手术干预对于PHH婴儿至关重要,以便为他们提供足够时间直至进行永久性分流。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bd3/10183253/6592483d4953/jkns-2022-0265f1.jpg

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