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Surgical management of intraventricular hemorrhage and posthemorrhagic hydrocephalus in premature infants

机译:早产儿脑室出血和鼻咽癌脑膜脑药的手术管理

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摘要

Perinatal intraventricular hemorrhage (IVH) with or without development of posthemorrhagic hydrocephalus (PHH) in premature neonates may lead to severe neurological disability. Although the percentage of preterm infants developing IVH has been greatly reduced in the last three decades, increased survival of these very immature infants has meant that large IVH with subsequent PHH is still a serious unsolved problem. Early cerebrospinal fluid diversion as a temporizing measure or a permanent shunt is the treatment of choice. This review summarizes the surgical modalities, techniques, and their complications in the management of IVH and PHH in premature infants. Though there is no level-one evidence to support the superiority of any of the currently available managements in the initial treatment of PHH over others, this review aims to provide pediatric neurosurgeons a comprehensive understanding of the pros and cons of various surgical treatment modalities, focusing on the temporizing measures before the infants is heavy enough to undergo ventriculoperitoneal shunt insertion. Based on the patient's condition, the facility and man power of the institution with minimal complication rate, the pediatric neurosurgeons may choose the best initial approach for the management of IVH and PHH in premature infants.
机译:在早产新生儿中有或不明显出现病症的脑室内出血(IVH)可能导致严重的神经疾病。虽然在过去三十年中,发育IVH的早产儿的百分比已经大大减少,但增加了这些不成熟的婴儿的增加的生存意味着随后的PHH的大IVH仍然是一个严重的未解决问题。早期脑脊液导流作为临时测量或永久分流器是选择的选择。本综述总结了外科偶像,技术及其在早产儿和PHH中的并发症。虽然没有一种级别的证据来支持任何目前可用管理的优势,但是初始治疗博语的初始治疗,旨在为儿科神经外科诊所提供全面了解各种外科治疗方式的优缺点,重点在婴儿足够沉重之前临时措施,以接受脑室内分流器插入。基于患者的状况,机构和人类的机构具有最小的并发症率,儿科神经外科医生可以选择早产儿中的IVH和PHH管理的最佳初始方法。

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