Li Hao,Chen Zhaohui,Fan Shuangshi,et al.Outcomes after initial Ommaya reservoir implantation for posthemorrhagic hydrocephalus secondary to neonatal intracranial hemorrhage and associated factors[J].Journal of Clinical Pediatric Surgery,,():118-123.[doi:10.3760/cma.j.cn101785-101785-20251021-00010]
Outcomes after initial Ommaya reservoir implantation for posthemorrhagic hydrocephalus secondary to neonatal intracranial hemorrhage and associated factors
- Keywords:
- Intracranial Hemorrhage; Infant; Newborn; Hydrocephalus; Drainage; Prognosis; Risk Factors
- Abstract:
- Objective To explore the risk factors for poor prognosis after initial Ommaya reservoir implantation in neonates with posthemorrhagic hydrocephalus (PHH) secondary to intracranial hemorrhage,and to provide evidence for clinical management and prognostic evaluation. Methods A retrospective analysis was conducted on the clinical data of 39 neonates with PHH who underwent initial Ommaya reservoir implantation in the Department of Neurosurgery,Children’s Hospital Affiliated to Xiangya School of Medicine,Central South University (Hunan Children’s Hospital) between June 2020 and March 2025.According to the improvement of PHH at 6 months after surgery,patients were divided into a good prognosis group (n=25) and a poor prognosis group (n=14).Data collected included age at surgery,body weight,gender,ASA classification,Papile grade,intraventricular hemorrhage,subdural hemorrhage,and subarachnoid hemorrhage.Univariate analysis and binary logistic regression were used to identify risk factors for poor prognosis. Results In the good prognosis group,Papile grade Ⅰ was observed in 2 cases (8%,2/25),grade Ⅱ in 9 cases (36%,9/25),and grade Ⅲ in 14 cases (56%,14/25).In the poor prognosis group,Papile grade Ⅱ was observed in 2 cases (14.29%,2/14),grade Ⅲ in 5 cases (35.71%,5/14),and grade Ⅳ in 7 cases (50%,7/14).The Papile grade in the poor prognosis group was significantly higher than that in the good prognosis group,with a statistically significant difference (P=0.001).There were no significant differences between the two groups in age at surgery,body weight,gender,ASA classification,intraventricular hemorrhage,subdural hemorrhage,or subarachnoid hemorrhage (P>0.05).Binary logistic regression analysis showed that a higher Papile grade was an independent risk factor for poor prognosis after Ommaya reservoir implantation in neonates with PHH secondary to intracranial hemorrhage (B=2.080,SE=0.749,Wald=7.711,P=0.005,OR=8.008,95%CI:1.844-34.753). Conclusions A higher Papile grade increases the risk of poor prognosis after Ommaya reservoir implantation in neonates with PHH secondary to intracranial hemorrhage.Enhanced perioperative management and long-term follow-up are recommended for patients with a high Papile grade.
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Memo
收稿日期:2025-10-21。
基金项目:湖南省卫生健康科研课题(20255753)
通讯作者:吴水华,Email:292454021@qq.com