Title Učestalost hidrocefalusa u djece liječene u Zavodu za intenzivnu pedijatriju KBC-a Split : retrospektivna studija
Title (english) Incidency of hydrocephalus in children treated in Pediatric Intensive Care Unit (PICU), Department of Pediatrics, University Hospital of Split : retrospective study
Author Mirja Biočić
Mentor Branka Polić (mentor)
Committee member Joško Markić (predsjednik povjerenstva)
Committee member Bernarda Lozić (član povjerenstva)
Committee member Zenon Pogorelić (član povjerenstva)
Granter University of Split School of Medicine Split
Defense date and country 2022, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Pediatrics
Abstract Cilj istraživanja: Cilj ovog istraživanja je istražiti pojavnost i analizirati demografske,
etiološke i kliničke karakteristike te načine dijagnostike i liječenja u djece s hidrocefalusom
liječene u Zavodu za intezivnu pedijatriju s postintezivnom skrbi Klinike za dječje bolesti KBCa
Split u razdoblju od 2006. do 2021. godine. Analizirana je povezanost dobi djeteta pri
postavljanju dijagnoze hidrocefalusa s obzirom na uzrok te utjecaj gestacijske dobi na uzrok
novorođenačkog hidrocefalusa.
Ispitanici i metode: Istraživanje je uključivalo 74 bolesnika koja su hospitalizirana prvi put
zbog novonastalog ili komplikacija hidrocefalusa. Sveukupno je bilo 89 prijema u Zavod jer su
neka od djece primljena veći broj puta zbog kasnijih komplikacija. Za dobivanje općih podataka
o ispitanicima i liječenju koristila se bolnička medicinska dokumentacija.
Rezultati: U našem istraživanju bilo je 89 prijema djece koji su liječeni zbog hidrocefalusa
među kojima je bilo 47 (53%) dječaka. Medijan vremena hospitalizacije iznoso je 12,5 dana.
Najveći udio prijema odnosio se na djecu < 4 godine (77%). Od 89 prijema njih 27 (30%) bilo
je zbog komplikacija od kojih je 10 (37%) zbog šant ventrikulitisa, a 9 (33%) zbog mehaničke
malfuncije VP šanta. Medijan vremena proteklog od postavljanja VP šanta do pojave šant
ventrikulitisa iznosi 1,5 mjeseca, a od bakterija najčešće je izoliran Koagulaza negativni
stafilokok. Najčešći simptomi i znakovi bili su u skupini djece <2 god poremećaj tonusa, napeta
fontanela i makrokranija, dok su u skupini djece >2 godine prevladavali glavobolja i
povraćanje. Od dijagnostike najčešće su korištene slikovne metode od kojih je CT korišten u
67% slučajeva. U liječenju većinom se koristilo postavljanje VP šanta u 64%
(novopostavljeni+revizija) i vanjska drenažavlikvora u 43% slučajeva. Među 89 prijema njih
74 primljeno je prvi put u kliniku zbog novonastalog hidrocefalusa (n=62) ili komplikacija.
Među njima, udio kongenitalnog hidrocefalusa bio je 24,3%, dok su najčešći stečeni uzroci u
djece ≤1 mjesec bili intrakranijalno krvarenje , a u djece >1 mjesec intrakranijalni tumori. Time
je nađena statistički značajna razlika uzroka hidrocefalusa u odnosu na dob (P<0,001). Od
ukupnog broja prijema (n=89) 15 ispitanika (17%) nije preživjelo bolničko liječenje, a njih 17
(19%) prebačeno je u drugu Kliniku na nastavak liječenja.
Zaključak: Hidrocefalus u djece složeno je stanje koje zahtijeva cjeloživotno praćenje te ako
se pravovremeno ne liječi može ostaviti velike neurološke posljedice u djeteta i jako brzo
dovesti do smrtnog ishoda. Etiologija može biti razna te uvelike ovisi o dobi djeteta.
Pravovremeno prepoznavanje kliničkih znakova i glavnih uzroka hidrocefalusa je važno kako
bismo što ranije započeli liječenje i poboljšali ishod.
Abstract (english) Objectives: The aim of this study is to investigate the incidence and analyze demographic,
etiological, and clinical characteristics, as well as diagnostic and treatment methods in children
with hydrocephalus treated in PICU, Department of Pediatrics, University Hospital of Splitfrom
2006. to 2021. The influence of gestational age on the cause of newborn hydrocephalus and the
correlation between the child's age and etiology in the diagnosis of hydrocephalus were
investigated.
Patients and methods: The study included 74 patients who were admitted to the hospital for
the first time due to the onset or complications of hydrocephalus. There were 89 admissions in
total because some of them were admitted multiple times due to subsequent complications.
General data on subjects and treatment were obtained from hospital medical records.
Results: In our study, 89 patients were admitted for hydrocephalus treatment with 47 (53%)
of them were male. The median length of stay in the hospital was 12.5 days. Children under the
age of four years had the highest proportion of admissions (77%). Of the 89 admissions, there
were 70% of newly established hydrocephalus and 30% were due to complications of which 10
(37%) were due to shunt ventriculitis , and 9 (33%) due to mechanical malfunction of VP shunt.
The most common symptoms and signs were, tense fontanelle, macrocrania and muscle tone
abnormalities in the group of children under 2 years old, while headaches and vomiting
predominated in older group. Imaging techniques were most frequently utilized for diagnostics
of which MSCT was in 60 (67%) cases. VP shunt installation (in 64% cases newly installed+
revision) and external cerebrospinal fluid drainage (in 43% cases) were the most frequently
utilized treatments. Proportion of congenital hydrocephalus was 24.3%. There was discovered
a statistically significant relationship between age and the causes of hydrocephalus (P<0.001)
because intracranial hemorrhage were the most frequent acquired causes in children under one
month, and in children over one month old were tumors. A total of 15 subjects (17%) out of the
89 admissions didn't survive hospital treatment.
Conclusion: Children with hydrocephalus have a complicated illness that requires lifelong care
and, if untreated, can have serious neurological effects and quickly result in death. The child's
age has a significant impact on the etiology. To begin treatment as soon as feasible and enhance
the outcome, it is critical to recognize the clinical symptoms of hydrocephalus as well as its
primary causes as soon as possible.
Keywords
hidrocefalus
cerebrospinalni likvor
posthemoragijski hidrocefalus
vanjska drenaža likvora
ventrikuloperitonejski šant
Keywords (english)
hydrocephalus
cerebrospinal fluid
posthemorrhagic hydrocephalus
external ventricular drainage
ventriculoperitoneal shunt
Language croatian
URN:NBN urn:nbn:hr:171:440884
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
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Created on 2022-09-22 11:33:41