Cagnoni G, Pancani S, Danti A, Pampaloni A
Sezione di Neurochirurgia, Ospedale Anna Meyer, Firenze.
Minerva Pediatr. 1995 May;47(5):187-91.
A series of 245 hydrocephalic patients in the pediatric age group who underwent 544 surgical shunting procedures is reviewed in this paper. The subsequent average of 1.5 operations per patient appears therefore significantly low, when compared with the Literature data. The authors emphasize that this result may be due mainly to the fact that all the surgical procedures were performed by the same surgeons, even if two other concepts appear extremely important in this regard: the great care in prevention of shunt infections and the use of one-piece shunting devices. A pattern for the "clinical surveillance" of hydrocephalic children is proposed and the neuropsychological follow-up of the series is described in the paper. Authors conclude that serious damage to cerebral parenchyma due to intracranial hypertension related to the hydrocephalic condition may be avoided by an accurate selection of patients to be operated on, a correct surgical timing and a careful postoperative control.
本文回顾了245例接受了544次外科分流手术的小儿脑积水患者。因此，与文献数据相比，每位患者随后平均1.5次的手术次数显得明显较低。作者强调，这一结果可能主要归因于所有外科手术均由同一组外科医生进行，尽管在这方面另外两个概念显得极为重要：预防分流感染时的高度谨慎以及一体式分流装置的使用。本文提出了小儿脑积水患者“临床监测”的模式，并描述了该系列患者的神经心理学随访情况。作者总结道，通过准确选择手术患者、正确把握手术时机以及术后认真监测，可以避免因脑积水相关颅内高压导致的脑实质严重损伤。
