科研之友
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摘要
Background: Since the external ventricular drainage (EVD) were introduced into clinical practice, it has been proven to be an efficacious treatment of cerebrospinal fluid (CSF) diversion, which results from intracranial hypertension, hydrocephalus, etc. But, this operation is prone to fail or lead to various complications, such as infection and intracerebral hemorrhage, especially for pediatric patients. Objective: This research aimed to retrospectively investigate the potential influence factors that affect the accuracy of lateral ventricle puncture in pediatric patients, as well as the efficacy of 3D-computed tomography (3D-CT) guidance during lateral ventricular puncture. That is, it is to determine how the success rate of lateral ventricle puncture could be improved for pediatric patients. Methods: 95 patients under the age of 18 years were identified into this retrospective analysis. All of them ever received lateral ventricle puncture, by the means of 3D-CT guidance or conventional CT. And then they also underwent conventional CT scanning after puncture in order to make sure the accuracy of catheterization. The distance between puncture point and interventricular foramen was measured in each case. The difference of 0.5 CM was adopted as a cut-off point, and the accuracy and depth of puncture were statistically analyzed. At last, logistic regression analysis was carried out to investigate the potential influence factors that affect the accuracy of lateral ventricle puncture. Results: On the basis of age and sex, these included pediatric patients were well matched between groups. And the primary disease covered hydrocephalus (46/95, 48.42%), spontaneous hemorrhage (19/95, 20%), head trauma (21/95, 22.11%), central nervous system malignancy (8/95, 8.42%), and postoperative observation (1/95, 1.05%). The success rate of catheterization was 81.2%, most catheter positions were good, and the CSF could be pumped out smoothly. The pivotal factors of lateral ventricle puncture included operator, age, sex, Glasgow coma scale score, disease categories. It can be included that pre-operative CT guidance contribute to promote the accuracy of lateral ventricle puncture significantly. Conclusions: These above results show that the success rate of lateral ventricle puncture can be affected by various factors, and CT guidance could significantly improve the success rate of catheterization, compared with freehand operation. Further studies evaluating external equipment guided ventricle puncture are still needed, especially for pediatric patients.
- 出版日期2018-6
- 单位深圳市儿童医院
