Methods for increasing the efficiency of hydrocephalus treatment in neonatal practice

Abstract

Posthemorrhagic hydrocephalus in newborns with ventricular occlusion leads to decompensation of CSF dynamics with a high risk of neurological disorders and child disability.Objective. To improve the effectiveness of treatment of hydrocephalus in newborns.Characteristics of children and research methods. The authors analyzed the treatment of hydrocephalus in 327 newborns in 2000– 2018. 184children (Group 1)underwent standard treatment with lumbar and ventricular punctures with 20-22G needles, and with progression of hydrocephalus – ventriculo-subgaleal drainage and ventriculo-peritoneal shunting. 143 children (Group 2) with ventricular occlusion underwentcomplex treatment with coronary-transluminal subarachnoventriculostomy (RF patent No. 2715535) and ventricular drainage with a ventriculo-subarachnoid stenting system (RF patent No. 2721455).Results. The effectiveness of treatment with the inclusion of the proposed options is improvedby eliminatingocclusion, restoring circulation and absorption of cerebrospinal fluid, prolonged sanitation of cerebrospinal fluid with isotonic sodium chloridesolution. A positive result with compensation for hydrocephalus was achievedin 75,4% of cases versus 28,2% with the «standard» protocol (p <0,001).Compensation of hydrocephalus was accompanied by regression of hypertensive symptoms, stabilization of the ventricular size. The authors demonstrate a decrease in the timethe child spent in the hospital after surgery to 3-6 weeks with dynamic observation after discharge in the follow-up room, neurovisual monitoring.>Conclusion. The data obtained allowus to consider the effectiveness of the inclusion of the proposed options in the modern algorithm for the treatment of hydrocephalus in newborns, to expand the possibilities for early rehabilitation and restorative treatment together with pediatricneurologists and doctors of related specialties.

Keywords

• новорожденные
• гидроцефалия
• стентирование
• эффективность лечения