内镜下脑积水的手术治疗(附32例报告)  

Neuroendoscopic Surgery for Hydrocephalus (Report of 32 Cases)

作　　者：蒋太鹏[1] 高永忠[1] 邓志刚[1] 廖宇钦[1] 林恒洲[1] 纪涛[1] 

机构地区：[1]深圳市第二人民医院神经外科,深圳518035

出　　处：《华中科技大学学报（医学版）》2004年第4期494-496,共3页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：目的　评价神经内镜对脑积水的治疗作用。方法　回顾性分析内镜下行不同治疗方式的 32例不同类型脑积水患者的临床资料。结果　随访 3月～ 2年 ,9例梗阻性脑积水采用内镜下脑室造瘘术 (7例行三脑室底造瘘术即ETV ,2例行透明隔造瘘 ) ,8例治疗有效 ,1例ETV后脑积水无明显改善 ,改行脑室腹腔分流术 (V P分流 ) ;2 3例交通性脑积水采用内镜下引导V P分流 (10例 )或内镜下引导V P分流加内镜下脑室造瘘术 (12例行ETV ,1例行透明隔造瘘 ) ,脑积水均获得改善。结论　梗阻性脑积水采用神经内镜脑室造瘘术 ,交通性脑积水采用内镜引导V P分流或内镜引导V P分流加脑室造瘘术 ,均可获得满意疗效。Objective To study the role of neuroendoscopy in the treatment of hydrocephalus. Methods A retrospective study was performed on the clinical data of 32 patients with various types of hydrocephalus subject to various surgical procedures under the neuroendoscopy. Results A follow-up of 3 months to 2 years was performed. Nine cases of obstructive hydrocephalus underwent neuroendoscopic ventriculostomy. Among them, 7 cases were subjected to neuroendoscopic third ventriculostomy (ETV) and the remaining 2 cases of monoventricular hydrocephalus to fenestration of septum pellucidum under the neuroendoscopy. The satisfactory results were obtained in 8 cases. One case was failed and then treated by ventriculoperitional shunt (V-P shunt). Twenty-three cases of communicating hydrocephalus were subjected to V-P shunt (10 cases) or V-P shunt plus ventriculostomy (12 cases undgoing ETV, one case canalization of septum pellucidum under the endoscopy). The conditions of hydrocephalus in 23 patients were all improved. Conclusion Treatment of obstructive hydrocephalus by neuroendoscopic ventriculostomy and that of the communicating hydrocephalus only with V-P shunt guided by endoscopy or in combination with endoscopic ventriculostomy can obtained satisfactory results.

关 键 词：内镜 脑积水 手术治疗 脑室造瘘术 

分 类 号：R651.11[医药卫生—外科学]