veoexrmpzt
Dołączył: 21 Lut 2011
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Skąd: England
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 Wysłany: Pon 7:26, 14 Mar 2011 Temat postu: mulberry bags wfj nzj gqiw xgf |
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,[link widoczny dla zalogowanych]
Shunt failure in children Endoscopic treatment of hydrocephalus
Mainly through the shunt to adjust the technology to remedy, and sometimes require many more adjustments. Ventriculoperitoneal shunt ventricular segment of a block,[link widoczny dla zalogowanych], mostly the choroid plexus or brain tissue caused by the wall plug the drainage port. Detectors, 6 cases in this article ventricular end of shunt tube, the side of the larvae L are choroid plexus brain tissue or wall plug. We isolated ventricular end of shunt underwent L side of the larvae choroid plexus cauterization,[link widoczny dla zalogowanych], the main purpose is to reduce the production of cerebrospinal fluid. Reduce the shunt obstruction, shunt surgery was wrapped freezing significantly reduced the opportunity TIF endoscopic third ventriculostomy (NTV) of cerebrospinal fluid absorption in obstructive hydrocephalus normal effective I3J. 4 fistula, but the arachnoid granulations of the absorption will not quickly restored or fully restored, only the symptoms of hydrocephalus improved or not improved, still can not completely improve hydrocephalus f4J. In the past we had a ventricular peritoneal shunt in children due to disease recurrence after TIF-line the third ventricle, shunt removed, but reappeared after the performance of hydrocephalus. Exploratory surgery and found that the Central Plains stoma smooth operation, and the diameter of the previous expansion, to consider due to malabsorption of cerebrospinal fluid. Accordingly,[link widoczny dla zalogowanych], in this group did not shunt surgery removed, but reserves the shunt, and to ensure the smooth lumen. In practice, we summarize notes during and after surgery: (1) position to select a knife 171 can be straight into the third ventricle. (2) Note that other structures in the brain room to avoid injury. (3) Third ventriculostomy greatest danger is the damage of the basilar artery, so the first position to the right, exactly. Guaranteed not to damage the basilar artery. Also, pay attention to the bottom of the third ventricle is a second layer of film, whether through, to ensure the success of fistula. (4) The operation of the third ventricle, we must pay attention to flushing flow rate and temperature to minimize traffic and reduce the temperature regulating center of hypothalamus stimulation. Reduce postoperative fever. (5) surgical drainage as far as possible to the 151 block of choroid isolated to ensure shunt patency. (6) of infant patients with 151 knife partial pressure bandage to prevent the fluid under the scalp. (7) for fever patients, simple use of antipyretic drugs or physical cooling methods imprecise. Recommendations of hormone treatment, attention and identification of intracranial infection. ( In order to prevent excessive diversion, intraoperative cerebrospinal fluid drainage should not be too fast, as far as possible after the supine position in children. NTV's development is now entering a new period, even in bypass surgery has failed to adjust shunt after the failure,[link widoczny dla zalogowanych], the success rate of 76.7% of shunt failure and the failure of cases adjust the shunt should not blindly be repeated adjustments, and should consider the line NTVt4]. For the treatment of obstructive hydrocephalus, the ventricles of a conventional shunt have more complications and higher recurrence rate, endoscopic surgery has been gradually replaced by neural f5j In short, by summing up the group of patients, we believe that Application of endoscope in children with shunt adjustments I clinical treatment failure, after all, a good way, with a minimally invasive, safe, accurate, less complications and economic advantages, is an important treatment for neurosurgery. In addition, the proposed preoperative isotope 99T ~ m_DTPA isotope cisternography shows the dynamic distribution and absorption observations to understand the absorption of cerebrospinal fluid, to guide further treatment options
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