临床小儿外科杂志2024，Vol.23Issue(9)：861-865,5.DOI:10.3760/cma.j.cn101785-202304073-011
两种手术治疗结核性脑膜脑炎并发脑积水的效果分析
Comparison and analysis of the effectiveness of two surgical treatments for tuberculous meningoenceph-alitis complicated with hydrocephalus
摘要
Abstract
Objective To evaluate the clinical efficacy of long tunnelled external ventricular drainage(LTEVD)versus Ommaya reservoir implantation and external drainage in treating tuberculous meningoencepha-litis 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 reser-voir implantation and external drainage group(Ommaya reservoir group)and LTEVD group based on the surgi-cal method.Pre-and post-operative cerebrospinal fluid indicators,changes in hydrocephalus,whether ventriculo-peritoneal 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 ana-lyzed.Results No significant differences were found between the two groups in pre-and post-operative cere-brospinal fluid white blood cell count,protein content,and glucose levels(P＞0.05).However,at post-opera-tive 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 reser-voir 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 intellec-tual,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 res-ervoir 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.关键词
结核性脑膜脑炎/脑积水/脑室外引流术/感染Key words
Tuberculous Meningoencephalitis/Hydrocephalus/External Ventricular Drainage/Infection引用本文复制引用
马宏图,周建军,纪文元,姜婷婷,杨贇莹,梁平,翟瑄,李禄生..两种手术治疗结核性脑膜脑炎并发脑积水的效果分析[J].临床小儿外科杂志,2024,23(9):861-865,5.基金项目
国家临床重点专科建设项目(国卫办医函[2013]544) （国卫办医函[2013]544）
重庆市科卫联合医学科研项目(2021MSXM014) National Key Clinical Specialty Construction Project(GWBYH[2013]544) （2021MSXM014）
Chongqing Kewei Joint Medical Scientific Research Project(2021MSXM014) （2021MSXM014）
