Liptak G S, Masiulis B S, McDonald J V
Acta Neurochir (Wien). 1985;74(3-4):113-7. doi: 10.1007/BF01418798.
Ventricular shunting has dramatically improved the care of children with hydrocephalus. Yet shunt malfunctions are extremely common and cause significant morbidity. To document shunt problems in children with a neural tube defect and hydrocephalus, 67 children born since 1973 were studied via life-table analysis. 28% of the shunts failed within the first 6 months after insertion, 37% failed within the first year and 50% failed by 4 1/2 years after insertion. Shunt survival was similar in children whether or not they had previous shunt failures. The brand of shunt system and pressure rating, the level of neurological function, the interval between closure of the neural tube lesion and shunt insertion, and head circumference percentile at the time of insertion were also not correlated with shunt failure. However, shunts inserted in the first year of life were much more likely to fail than those inserted after one year of age (p less than 0.05). 68% of the revisions required replacement of the ventricular catheter. Shunt failure from all causes of hydrocephalus accounted for approximately 1% of paediatric admissions to Strong Memorial Hospital in 1982 with a mean cost of $4,543 and a mean length of stay of 9 days. Thus shunt problems remain both common and serious.
脑室分流术极大地改善了脑积水患儿的治疗效果。然而，分流器故障极为常见，并会导致严重的发病率。为了记录神经管缺陷合并脑积水患儿的分流问题，我们通过寿命表分析对1973年以来出生的67名儿童进行了研究。28%的分流器在植入后的前6个月内出现故障，37%在第一年内出现故障，50%在植入后4年半内出现故障。无论患儿此前是否有分流器故障，其分流器的使用寿命相似。分流器系统的品牌和压力额定值、神经功能水平、神经管病变闭合与分流器植入之间的间隔时间以及植入时的头围百分位数也与分流器故障无关。然而，出生后第一年内植入的分流器比一岁以后植入的分流器更容易出现故障（p小于0.05）。68%的修复手术需要更换脑室导管。1982年，因各种脑积水原因导致的分流器故障约占斯特朗纪念医院儿科住院病例的1%，平均费用为4543美元，平均住院时间为9天。因此，分流器问题仍然既常见又严重。
