To Study Preoperative And Postoperative Cognitive Dysfunction Of Children’ Scongenital Hydrocephalus In Xinjiang

Objective:1) The objective of this systematic review was to examine the existing literature comparing CSF shunts and endoscopic third ventriculostomy (ETV) for the treatment of pediatric hydrocephalus and to make evidence-based recommendations regarding the selection of surgical technique for this condition; 2) The research of the children’s neurocognitive function changes after third ventriculostomy of hydrocephalus. 3) Comprehensive discussion the children’s neurocognitive function changes after third Ventriculos tomy and Ventriculoperitoneal shunt of hydrocephalus. Methods:1) Both the US National Library of Medicine and the Cochrane Database of Systematic Reviews were queried using MeSH headings and key words specifically chosen to identify published articles detailing the use of CSF shunts and ETV for the treatment of pediatric hydrocephalus. Articles meeting specific criteria that had been determined a priori were examined, and data were abstracted and compiled in evidentiary tables. These data were then analyzed by the Pediatric Hydrocephalus Systematic Review and Evidence-Based Guidelines Task Force to consider treatment recommendations based on the evidence; 2) Retrospective analysis of the medical files of 43 cases of children with hydrocephalus, including the endoscopic third ventriculostomy of 20 cases (Operation Group). The data regarding CT/MRI, EEG, SPECT, developmental quotient (DQ) before and after surgery were studied. Evaluation of the children after surgery neurocognitive function recovery time and degree effect. Surgery is not done in 23 cases (without operation group), in which developmental quotient (DQ) is measured after two weeks,2 month and 6 months of the diagnosis; 3) Retrospective analysis of the medical files of 70 cases of children with hydrocephalus, including the endoscopic third ventriculostomy of 20 cases (ETV Group) and the Ventriculoperitoneal shunt of 27cases (VP Group). The data regarding CT/MRI, EEG, SPECT, developmental quotient (DQ) before and after surgery were studied. Evaluation of the children after surgery neurocognitive function recovery time and degree effect.Surgery is not done in 23 cases (without operation group), in which developmental quotient (DQ) is measured after two weeks,2 month and 6 months of the diagnosis; Results:1) Of the 284 articles identified using optimized search parameters,54 were recalled for full-text review. Fourteen articles met al.1 study criteria and contained comparative data on CSF shunts and ETV. In total,6 articles were accepted for inclusion in the evidentiary table; 8 articles were excluded for various reasons. The tabulated evidence supported the evaluation of CSF shunts versus ETV; 2) The ETV group and without operation group after 2 month and 6 months of operation were compared developmental quotient difference were significant (P<0.05). In ETV group:2 month and 6months after operation compared with the preoperative developmental quotient have difference, ETV group developmental quotient (DQ) value shows ascendant trend change. Postoperative ventricle size compared with the preoperative change significantly. The EEG abnormal rate, ECT cerebral blood perfusion imaging compared with preoperative difference were significant; 3) The VP group and without operation group after 2 month and 6 months of operation were compared developmental quotient difference were significant (P<0.05). In VP group:2 month and 6months after operation compared with the preoperative developmental quotient difference were significant, VP group developmental quotient (DQ) value shows ascendant trend change. Postoperative ventricle size compared with the preoperative change significantly. The EEG abnormal rate, ECT cerebral blood perfusion imaging compared with preoperative difference were different. The ETV group compared with the VP group have not different in developmental quotient (DQ) value changes. In ETV group after operation the developmental quotient (DQ) value of infants compared with elder children were significant (P<0.05).In VP group the developmental quotient (DQ) value of infants compared with elder children were not significant (P>0.05). The infants developmental quotient (DQ) value improvement have significant difference after ETV or VPS, respectively. Conclusions:1) Cerebrospinal fluid shunts and ETV demonstrated equivalent outcomes in the clinical etiologies studied; 2) Children after ETV can make neurocognitive function recovery, postoperative ventricular size change and improve is obvious. Two operation procedure have no different in neurocognitive function recovery; 3) Children after ETV and V-P shunt can make neurocognitive function recovery, postoperative ventricular size change and improve is obvious.The infants underwent ETV shew no appreciable improvement of development at 2 months after the initial procedure.The infants, we suggest, choose the VPS for early neurocognitive function recovery.