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目的探讨脑室内出血后脑积水早产儿埋植Ommaya囊治疗期间相关并发症、预防措施及临床转归。方法收集我院2009年6月至2011年6月Ⅲ度以上脑室内出血合并脑积水、并行Ommaya囊埋植治疗的患儿,统计埋植后治疗期间相关并发症及治疗效果。结果共入选18例患儿,Ommaya囊埋植后经储液囊抽液期间常见并发症为颅内出血(3例)、颅内感染(3例)、Ommaya囊漏液(1例)、引流管堵塞(1例)及头皮感染(1例)。随访期间3例患儿脑室形态稳定行Ommaya囊取出术,12例脑室进行性增大行脑室镜第三脑室造瘘或脑室腹腔分流术,3例因合并其他疾病家长放弃治疗。结论 Ommaya囊埋植是治疗早产儿脑室出血后脑积水的重要方法,经储液囊抽液时应加强对患儿家长宣教,多数家长可掌握抽液方法及无菌操作;大部分患儿最终需行永久性分流术或脑室造瘘术。
Objective To investigate the complications, preventive measures and clinical outcomes during Ommaya capsule implantation in preterm infants with hydrocephalus after intraventricular hemorrhage. Methods We collected children with grade Ⅲ or higher intracerebral hemorrhage complicated with hydrocephalus and treated with Ommaya embedding in our hospital from June 2009 to June 2011. The complication and therapeutic effect were observed after implantation. Results A total of 18 children were enrolled in this study. The common complication of intracranial hemorrhage (3 cases), intracranial infection (3 cases), Ommaya capsule leakage (1 case), drainage tube Blockage (1 case) and scalp infection (1 case). During the follow-up, Ommaya capsule removal was performed in 3 patients with stable ventricular morphology. Ventricular ventriculostomy or ventriculoperitoneal shunt was performed in 12 patients with progressive ventricle. Three patients were given up for treatment due to other diseases. Conclusion Ommaya capsule implantation is an important method for the treatment of hydrocephalus after ventricular hemorrhage in premature infants. When the fluid reservoir is drained, the parents should be educated. Most parents can master the pumping method and aseptic operation. Most of the patients eventually Need to be a permanent shunt or ventriculostomy.