Gamache F W
New York Hospital-Cornell Medical Center, New York 10021, USA.
Childs Nerv Syst. 1995 Aug;11(8):487-8. doi: 10.1007/BF00334972.
Meningomyelocele/encephalocele with associated ventriculomegaly can be treated as a single-stage procedure (i.e., both lesions treated simultaneous) or as two-stage procedures (i.e., each lesion treated at a separate time). A delay in closure of the meningomyelocele/encephalocele is associated with a higher incidence of ventriculitis/ventricular shunt infection-particularly when closure is performed more than 36 h after birth. In these situations, closure followed by surveillance cultures, appropriate antibiotics, ventricular drainage, and then delayed ventricular shunting seems more reasonable.
伴有相关脑室扩大的脊髓脊膜膨出/脑膨出可作为一期手术治疗(即同时处理两个病变)或作为二期手术治疗(即分别在不同时间处理每个病变)。脊髓脊膜膨出/脑膨出闭合延迟与脑室炎/脑室分流感染的发生率较高相关,尤其是在出生后36小时以上进行闭合时。在这些情况下,先进行闭合,然后进行监测培养、使用适当抗生素、脑室引流,再延迟进行脑室分流似乎更为合理。