Ommaya囊联合脑室外引流改善新生儿脑室周围-脑室出血后神经功能预后

邹彬; 唐俊; 周渝冬; 陈小兵; 赵雪灵; 梁平; 于增鹏

doi:10.16016/j.2097-0927.202203222

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Ommaya囊联合脑室外引流改善新生儿脑室周围-脑室出血后神经功能预后

临床医学 | 更新时间：2026-01-09

- Ommaya囊联合脑室外引流改善新生儿脑室周围-脑室出血后神经功能预后
- Effectiveness of Ommaya sac combined with external ventricular drainage in improving neurological outcome after periventricular-intraventricular hemorrhage in neonates
- 陆军军医大学学报 2022年44卷第17期页码：1778-1784
- 作者机构：
  
  400014 重庆，重庆医科大学附属儿童医院神经外科，国家儿童健康与疾病临床医学研究中心，儿童发育疾病研究教育部重点实验室，儿科学重庆市重点实验室
- 作者简介：
  
  [梁平，E-mail：liangping868@sina.comLIANG Ping, E-mail: liangping868@sina.com
- 基金信息：
  
  国家自然科学基金面上项目(81971217);重庆市科卫联合医学科研项目(2018MSXM110)
- DOI：10.16016/j.2097-0927.202203222
  中图分类号： R181.32;R726.511;R743.34
- 收稿：2022-03-24，
  
  修回：2022-04-04，
  
  纸质出版：2022-09-15
- 稿件说明：
移动端阅览
邹彬, 唐俊, 周渝冬, 等. Ommaya囊联合脑室外引流改善新生儿脑室周围-脑室出血后神经功能预后[J]. 陆军军医大学学报, 2022,44(17):1778-1784.

Bin ZOU, Jun TANG, Yudong ZHOU, et al. Effectiveness of Ommaya sac combined with external ventricular drainage in improving neurological outcome after periventricular-intraventricular hemorrhage in neonates[J]. Journal of Army Medical University, 2022, 44(17): 1778-1784.
邹彬, 唐俊, 周渝冬, 等. Ommaya囊联合脑室外引流改善新生儿脑室周围-脑室出血后神经功能预后[J]. 陆军军医大学学报, 2022,44(17):1778-1784. DOI： 10.16016/j.2097-0927.202203222.

Bin ZOU, Jun TANG, Yudong ZHOU, et al. Effectiveness of Ommaya sac combined with external ventricular drainage in improving neurological outcome after periventricular-intraventricular hemorrhage in neonates[J]. Journal of Army Medical University, 2022, 44(17): 1778-1784. DOI： 10.16016/j.2097-0927.202203222.

摘要

目的

评价Ommaya囊联合脑室外引流改善新生儿脑室周围-脑室出血(periventricular-intraventricular hemorrhage，PIVH)后神经功能预后的有效性。

方法

本研究采用回顾性队列研究设计方案，筛选重庆医科大学附属儿童医院新生儿科、神经外科2015年1月至2020年7月住院诊断为PIVH的新生儿病例，根据治疗方法分为Ommaya囊联合脑室外引流手术治疗组(手术组)和非手术组，随访观察至矫正12月龄。统计分析2组患儿早期脑脊液炎症因子浓度、随访期间并发症(癫痫、脑积水、脑瘫、死亡)发生率以及神经发育预后情况。

结果

共入组71例患儿，其中Ommaya囊联合脑室外引流手术治疗35例，非手术治疗患儿36例。手术组术后3 d后脑脊液神经元烯醇化酶(neuron en

olase，NSE)、神经生长因子(nerve growth factor，NGF)、中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio，NLR)水平较术前显著下降(

0.05)；非手术组上述指标在治疗后3 d变化无统计学差异(

0.05)。随访至校正12月龄时，手术组死亡1例(2.9%)，非手术组死亡6例(16.7%)。手术组和非手术组其余PIVH并发症发生比较如下：癫痫(0例

2例)、脑积水(4例

9例)、脑瘫(1例

3例)，差异均具有统计学意义(

0.05)。Gesell发育量表评分提示手术组存活患儿在适应性、精细动作、语言、个人社交等能区的发育显著优于非手术组(

0.05)。

结论

Ommaya囊联合脑室外引流较非手术治疗显著降低中、重度PIVH新生儿脑脊液中炎症因子浓度，有效降低PIVH并发症发生率，改善神经功能预后。

Abstract

Objective

To evaluate the effectiveness of Ommaya sac combined with external ventricular drainage in improving neurological function after periventricular-intraventricular hemorrhage (PIVH) in neonates.

Methods

A retrospective cohort study was carried out on the neonates hospitalized due to PIVH in the neonate and neurosurgery departments in our hospital from January 2015 to July 2020. They were divided into Ommaya sac combined with external ventricular drainage surgery group (surgery group) and non-surgery group. All of them were followed up until they were 12 months old. The concentration of inflammatory factors in cerebrospinal fluid in the early stage

the incidence of complications (epilepsy

hydrocephalus

cerebral palsy

and death) during follow-up

and neurodevelopmental outcomes were observed and analyzed in the 2 groups.

Results

A total of 71 PIVH neonates were enrolled

including 35 cases treated with Ommaya capsule combined with external ventricular drainage

and 36 cases treated without surgery. The levels of neuron enolase (NSE)

nerve growth factor (NGF) and neutrophil-to-lymphocyte ratio (NLR) in the cerebrospinal fluid in 3 d after surgery were significantly decreased than the levels before surgery (

0.05). In the non-surgery group

no such differences i

n the above indexes were seen in 3 d after treatment (

0.05). During the follow-up to 12 months of corrected age

1 neonate (2.9%) died in the surgery group and 6 neonates (16.7%) died in the non-surgery group. The incidences of complications in the surgery group and non-surgery group were compared as follows: epilepsy (0

2 cases)

hydrocephalus (4

9 cases) and cerebral palsy (1

3 cases)

and statistical differences were seen in the incidences (

0.05). Gesell Developmental Scale score indicated that the developmental of the surviving children in the surgery group were significantly better than those in the non-surgery group in terms of adaptability

fine motor

language and personal social interaction (all

0.05).

Conclusion

Compared with non-surgical treatment

Ommaya sac combined with external ventricular drainage significantly reduces the concentration of inflammatory factors in the cerebrospinal fluid of neonates with moderate and severe PIVH

effectively decreases the incidence of PIVH complications

and improves the prognosis of neurological function.

关键词

Keywords

references

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