Investigation Of Related Risk Factor Of Shunt Malfunction Of Hydrocephalic Infant After Ventriculoperitoneal Shunt

Objective:To investigate the related risk factor of Shunt Malfunction of Hydrocephalic Infant after Ventriculoperitoneal Shunt.In order to provide a guide to select relevant preoperative test,screening high-risk group of cases,implement predictive treatment before and after Ventriculoperitoneal Shunt surgery.Methods:A retrospective study was designed and a total of 125 Hydrocephalic Infant(0-3 years of age ) hospitalized in the Guangdong General Hospital , department of neurosurgery from Jan.2003 to Dec.2009 were included in our study. Among these cases,52 had shunt malfunction after ventriculoperitoneal shunt surgery because of different kinds of reasons(shunt malfunction),and 73 had ventriculoperitoneal shunt surgery and no complications in 2 year's follow-up visit)(control group). (1) Observe the frequency distribution of the duration of shunt malfunction.(2) Screen the risk factors of shunt malfunction after ventriculoperitoneal shunt surgery. (3)Research the relevance of different risk factors of shunt malfunction, and rank the relevant factors in order. All data was analyzed by SPSS 13.0.Results:1. The objective risk factors of shunt malfunction after ventriculoperitoneal shunt surgery are pre-operative cerebrospinal fluid protein level, pre-operative cerebrospinal fluid cell count, site of distal catheter,etc.2. The frequency distribution of shunt malfucntion after ventriculoperitoneal shunt surgery shows the peaks of morbidity are the first month after surgery,and from the 12th month to the 24^th month after surgery.3. In all the objective risk factors,the sequence which order by the relevance is pre-operative cerebrospinal fluid cell count, pre-operative cerebrospinal fluid protein level, age, site of distal catheter, pre-operative albumin level of blood.Conclusions:1. The objective risk factor's sequence which order by the relevance of shunt malfunction is pre-operative cerebrospinal fluid cell count, pre-operative cerebrospinal fluid protein level, age, site of distal catheter,pre-operative protein level of blood.2. The risk of distal catheter site in frontal horn area in VPS is much fewer than it in posterior horn area;the higher pre-operative cerebrospinal fluid cell count and protein level, the higher risk of shunt malfunction after VPS;the elder age and(or) higher pre-operative protein level of blood, the lower risk of shunt malfunction after VPS.3. We did not find any association of shunt malfunction with preoperative APTT or preoperative ventricle size.