Cao Hongbin,Cao Hongxu,Guo Genrui,et al.Application of a parieto-occipital ventricular catheter ruler for ventriculoperitoneal shunting[J].Journal of Clinical Pediatric Surgery,2019,18(08):703-706.[doi:10.3969/j.issn.1671-6353.2019.08.017]
经枕角脑室穿刺定位器在脑室腹腔分流术中的应用
- Title:
- Application of a parieto-occipital ventricular catheter ruler for ventriculoperitoneal shunting
- Keywords:
- Hydrocephalus; Ventriculoperitoneal Shunt; Ventricular Puncture; Ventricular Catheter; Localizer
- 分类号:
- R651.1+1;R742.7
- 摘要:
- 目的 目前经枕角脑室穿刺是儿童脑积水脑室腹腔分流术中采用的主要穿刺路径，但经枕角穿刺较经额角穿刺困难，易出现分流管脑室端位置不满意等情况。本文介绍一种经枕角脑室穿刺定位器，并初步应用于临床，观察其效果。方法 2016年5月至2017年11月，采用经枕角脑室穿刺定位器辅助行脑室腹腔分流术治疗儿童脑积水患儿36例，其中男童26例，女童10例，年龄1个月至10岁，平均年龄19个月。先天性脑积水23例，肿瘤引起的脑积水7例，出血引起的脑积水3例，感染引起的脑积水3例。脑室穿刺绝大部分采用经右侧枕角入路，采用经枕角脑室穿刺定位器辅助分段穿刺法行脑室穿刺。结果 所有患儿均1次穿刺成功，无术中并发症发生，无深部血管损伤出血，无意外的神经损伤。位置满意率100%。随访18个月，均无脑室端梗阻发生。结论 经枕角脑室穿刺定位器能显著提高脑室腹腔分流术中脑室端位置满意率。
- Abstract:
- Objective The parieto-occipital approach is a major approach of ventriculoperitoneal shunting for pediatric hydrocephalus.However,it is more difficult than the frontal approach and more likely to make an inappropriate ventricular catheter position.A parieto-occipital ventricular catheter ruler was applied for ventriculoperitoneal shunting in children and the clinical efficacies were tested.Methods Retrospective analysis was performed for 36 children with hydrocephalus undergoing ventriculoperitoneal shunting via a parieto-occipital ventricular catheter ruler from May 2016 to November 2017.There were 26 boys and 10 girls with a mean age of 19(1-120) months.The causes were congenital (n=23),brain-tumor-related (n=7),post-hemorrhagic (n=3) and post-infective (n=3).The parieto-occipital ventricular catheter ruler was adopted with a 2-segmented puncture through a right parieto-occipital approach.Results All cases were successfully punctured on one try.There was no onset of intraoperative complication,deep vascular injury or accidental nervous injury.The appropriate ventricular catheter position rate was 100%.No ventricular catheter obstruction occurred during a follow-up period of 18 months.Conclusion The parieto-occipital ventricular catheter ruler can significantly improve the appropriate ventricular catheter position rate during ventriculoperitoneal shunting.
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备注/Memo
收稿日期:2018-01-15。
基金项目:河北省医学科学研究重点课题计划（编号：20170383）
通讯作者:王贤书,Email:sjxwk99@163.com