Ma Hongtu,Zhou Jianjun,Ji Wenyuan,et al.Comparison and analysis of the effectiveness of two surgical treatments for tuberculous meningoencephalitis complicated with hydrocephalus[J].Journal of Clinical Pediatric Surgery,,():861-865.[doi:10.3760/cma.j.cn101785-202304073-011]
Comparison and analysis of the effectiveness of two surgical treatments for tuberculous meningoencephalitis complicated with hydrocephalus
- Abstract:
- Objective To evaluate the clinical efficacy of long tunnelled external ventricular drainage (LTEVD) versus Ommaya reservoir implantation and external drainage in treating tuberculous meningoencephalitis complicated with hydrocephalus. Methods A retrospective analysis of clinical data from children treated surgically for tuberculous meningoencephalitis complicated with hydrocephalus at Children’s Hospital of Chongqing Medical University from January 2016 to March 2022.Patients were divided into the Ommaya reservoir implantation and external drainage group (Ommaya reservoir group) and LTEVD group based on the surgical method.Pre-and post-operative cerebrospinal fluid indicators,changes in hydrocephalus,whether ventriculoperitoneal shunt (VPS) was ultimately performed,scores of intellectual,language,and behavioral development,and the occurrence of secondary infection or cerebrospinal fluid leakage were collected and statistically analyzed. Results No significant differences were found between the two groups in pre-and post-operative cerebrospinal fluid white blood cell count,protein content,and glucose levels (P>0.05).However,at post-operative days 10,20,and 30,the LTEVD group showed better improvement in cerebrospinal fluid monocyte ratio and chloride levels compared to the Ommaya reservoir group (P<0.05).Six cases (75%) in the Ommaya reservoir group and five cases (45%) in the LTEVD group ultimately underwent VPS,with no significant difference (P>0.05).Among children aged 0 to 6 years,the LTEVD group showed significant improvements in intellectual,language,and behavioral development compared to the Ommaya reservoir group (P<0.05).Neither group experienced drainage tube blockage or cerebrospinal fluid leakage,but 4 cases (50.00%) in the Ommaya reservoir group developed post-operative secondary infections,while no such infections occurred in the LTEVD group (P<0.05). Conclusions LTEVD is significantly effective in improving cerebrospinal fluid properties and promoting intellectual,language,and behavioral development in children aged 0 to 6 years with tuberculous meningoencephalitis complicated with hydrocephalus,with a lower risk of post-operative secondary infections compared to the Ommaya reservoir group.
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Memo
收稿日期:2023-4-29。
基金项目:国家临床重点专科建设项目(国卫办医函[2013]544);重庆市科卫联合医学科研项目(2021MSXM014)
通讯作者:周建军,Email:258276230@qq.com