The external ventricular drainage in the ventricular abdominal shunt replacement in children
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摘要:
目的探讨脑室外引流在小儿脑室腹腔分流管更换术中的作用。 方法回顾性研究近10年在我院诊治的155例需要更换腹腔分流管更换的患儿，分析脑室外引流对减少术后并发症（出血、感染、堵管）的作用。 结果更换脑室腹腔分流管是安全，有效的。105例直接更换脑室腹腔分流管的患儿中，20例发生术后并发症（发生率19%）。另一组病人（50例），拔除原脑室腹腔分流管后，行脑室外引流，待脑脊液正常后再次行脑室-腹腔分流术。脑室外引流能显著减少术后并发症。 结论小儿脑室腹腔分流管更换术中，如发现拔管困难、脑脊液浑浊或者出血，放置脑室外引流管，待脑脊液正常后再次行脑室-腹腔分流术，能显著减少术后并发症。 Abstract:Objective To assess the usage of external ventricular drainage in the ventricular abdominal shunt replacement in children. Method We analyzed retrospectively 155 patients who needed ventricular abdominal shunt replacement in the past 10 years. And we assessed the effect of external ventricular drainage on postoperative complications, including obstruction, bleeding, and infection. Results The study showed that ventricular abdominal shunt replacement is safe and effective. 105 cases had replaced the ventricular abdominal shunt directly, among them 20 patients had postoperative complications (19%). While in another group who were given external ventricular drainage firstly because of some difficult situations, only one patient had postoperative obstruction. The external ventricular drainage could decrease dramatically the postoperative complications. Conclusions External ventricular drainage placement firstly, and then a new ventricular abdominal shunt placement is safer and could decrease dramatically the postoperative complications in the cases whose shunt pulling was difficult, bleeding or had unclear cerebral spinal fluid. -
表 1 脑室腹腔分流管更换术后并发症
组别 并发症名称 例数 直接换管 分流管再次堵塞 15 脑室内出血 4 颅内感染 1 先行脑室外引流，再次分流术 分流管再次堵塞 1 脑室内出血 0 颅内感染 0 
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