Quality of life in children with hydrocephalus treated with endoscopic third ventriculostomy.
Quality of life in children with hydrocephalus treated with endoscopic third ventriculostomy.
复制标题
内镜下第三脑室造口术治疗脑积水儿童的生活质量。
DOI：
10.3171/2020.8.peds20384
复制
发表时间：
2021
期刊：
影响因子：
--
通讯作者：
M. Arráez
中科院分区：
文献类型：
--
作者：
Á. Ros;Sara Iglesias;B. Ros;F. Rius;A. Delgado;M. Arráez
客观化
本研究的目的是使用脑积水结果问卷西班牙语版(Hoq-Sv)，确定接受内窥镜第三脑室吻合术(ETV)治疗的脑积水患儿的生活质量，并研究与功能状态好坏相关的临床和放射学因素。
方法
这项横断面研究是在2018年9月至2019年12月期间进行的。它包括40名接受ETV治疗的5至18岁脑积水患者。如果在至少6个月的随访后不需要手术治疗脑积水，则认为ETV是成功的。临床变量包括性别、确诊为脑积水时的年龄、ETV时的年龄、完成问卷时的年龄、脑积水的病因和类型(是否沟通)、既往分流、重复ETV、神经外科手术次数、癫痫发作次数、体征和直到最后一次办公室翻修的随访时间。放射学变量为Evans指数和治疗前后额枕角比率。所有这些变量与患者父母通过电话或在门诊完成的HOQ-Sv上的各个维度之间的关联进行了分析。
结果
ETV儿童的平均年龄为7岁(7-194个月)，完成调查问卷后的平均年龄为12岁(60-216个月)。平均HOQ得分如下：总体0.82分，身体领域0.86分，社会情绪(SE)领域0.84分，认知领域0.75分，效用得分0.90分。癫痫危象病史是整体以及SE和认知领域得分较差的预测因素。在物理领域得分较差的相关因素是先前的分流术、手术次数以及脑积水的病因和类型。从ETV到最后一次办公室访问的平均随访时间为5年(64.5个月)。未发现脑室缩小程度与生活质量之间的关系。
结论
与不同维度的HOQ评分较差相关的因素是癫痫发作史、手术次数、交通性脑积水和有瓣膜病史。根据HOQ-Sv的测量，没有发现脑室大小的缩小和生活质量之间的联系。
OBJECTIVE
The objectives of this study were to determine the quality of life of a pediatric cohort with hydrocephalus treated by endoscopic third ventriculostomy (ETV), using the Hydrocephalus Outcome Questionnaire-Spanish version (HOQ-Sv), and study the clinical and radiological factors associated with a better or worse functional status.
METHODS
This cross-sectional study was undertaken between September 2018 and December 2019. It comprised a series of 40 patients ranging from 5 to 18 years old with hydrocephalus treated by ETV. ETV was considered to be successful if there was no need for surgery for the treatment of hydrocephalus after a minimum follow-up of 6 months. The clinical variables included gender, age at hydrocephalus diagnosis, age at the time of ETV, age at completion of the questionnaire, etiology and type of hydrocephalus (communicating or not), prior shunt, repeat ETV, number of neurosurgical procedures, number of epileptic seizures, presenting signs, and follow-up duration until last office revision. The radiological variables were the Evans Index and the pre- and posttreatment frontooccipital horn ratio. An analysis was conducted of the association between all these variables and the various dimensions on the HOQ-Sv, completed by the parents of the patients via telephone or in the outpatient offices.
RESULTS
The mean age of the children at ETV was 7 years (range 7-194 months), and on completing the questionnaire was 12 years (range 60-216 months). The mean HOQ scores were as follows: overall 0.82, physical domain 0.86, social-emotional (SE) domain 0.84, cognitive domain 0.75, and utility score 0.90. A history of epileptic crises was a predictive factor for a worse score overall and in the SE and cognitive domains. Factors related to a worse score in the physical domain were a previous shunt, the number of procedures, and the etiology and type of hydrocephalus. The mean follow-up duration from ETV to the last office visit was 5 years (64.5 months). No association was found between the degree of ventricular reduction and the quality of life.
CONCLUSIONS
The factors related to a worse score in the different dimensions of the HOQ were a history of epileptic seizures, the number of procedures, communicating hydrocephalus, and having had a previous valve. No association was found between the reduction in ventricular size and the quality of life as measured on the HOQ-Sv.