目的:感染后脑积水(PIH)是一种脑积水,发生在脑或脑脊液(CSF)感染后。PIH的治疗需要临时措施,例如外部心室引流(EVD)和脑室下分流(VSGS),直到CSF变得清晰并准备实施VP分流。已经进行了有限的研究来探索这些方法之间的权衡,特别是在小儿PIH患者中。我们的研究比较了并发症,死亡率,以及这两个程序的使用资源成本。
方法:进行了为期18个月的前瞻性研究,我们比较了VSGS和EVD对PIH的治疗,涉及42例随机病例,其中A组21例患者接受VSGS手术,B组21例患者接受EVD手术。
结果:我们的结果显示两组在实施VSGS/EVD直至感染消退的持续时间上存在统计学上的显著差异。此外,EVD组的儿科重症监护病房(PICU)入院率较高,住院时间(LOS)较长.尽管形式不同,但两者发生的并发症数量之间没有统计学上的显着差异。此外,两组的死亡率几乎相似.
结论:对于PIH,VSGS和EVD的并发症发生率无显著差异。基于此,VSGS作为PIH管理的一种有利且具有成本效益的选择,可以减轻患者和国家卫生资源的经济负担,尤其是在发展中国家。
OBJECTIVE: Post infective hydrocephalus (PIH) is a type of hydrocephalus which occurs after an infection of the brain or cerebrospinal fluid (CSF). Treatment of PIH requires temporary measures such as external ventricular drain (EVD) and ventriculosubgaleal shunt (VSGS) until CSF becomes clear and ready to implement VP shunt. Limited research has been done to explore the tradeoff between these approaches particularly in pediatric PIH patients. Our study compares the complications, mortality rates, and the cost of used resources of both procedures.
METHODS: A prospective study was conducted for 18 months in which we compared between VSGS and EVD for management of PIH involving 42 randomized cases with 21 patients in group A operated by VSGS and 21 patients in group B operated by EVD.
RESULTS: Our results show a statistically significant difference between both groups in the duration of implementation of VSGS/EVD until resolution of infection occurs. Additionally, a higher rate of pediatric intensive care unit (PICU) admission and a longer length of hospital stay (LOS) were recorded among the EVD group. No statistically significant difference between the number of complications that happened in both despite variations in their forms. Moreover, both groups showed nearly similar mortality rates.
CONCLUSIONS: There is no significant difference in the rate of complications between VSGS and EVD for PIH. Based on that, VSGS emerges as a favorable and cost-effective option for the management of PIH which leads to less economic burden on patients and the country\'s health resources, especially in developing countries.