神经内镜治疗梗阻性脑积水(附20例报告)  

Treatment of obstructive hydrocephalus with neuroendoscope with attached report of 20 cases

作　　者：陈东亮[1] 彭玉平[2] 谢庆海[1] 彭涛[1] 蒙芝健[1] 

机构地区：[1]钦州市第一人民医院脑科,广西535002 [2]南方医科大学南方医院神经外科,广州510515

出　　处：《中华神经医学杂志》2006年第4期419-420,共2页Chinese Journal of Neuromedicine

摘　　要：目的总结神经内镜下手术治疗20例梗阻性脑积水的临床经验。方法 17例为导水管阻塞引起的双侧型脑积水,另3例为单侧室问孔堵塞引起的单侧型脑积水;17例用神经内镜经侧脑室额角入路,经室间孔行第三脑室底脚问池造瘘,3例透明隔造瘘治疗。结果所有造瘘过程均顺利,瘘口通畅。17例双侧型脑积水行单纯第三脑室底造瘘术,15例效果满意,2例无效,改行内镜引导下的脑室-腹腔分流术治愈,另3例单侧型脑积水行透明隔造瘘,效果良好。总有效率达到90．0％。结论神经内镜治疗梗阻性脑积水简便、微创、有效,是首选的方法。Objective To summarize the experience of surgery therapy of hydrocephalus caused by obstruction with neuroendoscope from 20 cases. Methods 17 cases with two-side type hydrocephalus was due to aqueduct obstruction ;3 cases with one-side type hydrocephalus was due to foramen of Monro obstruction. In 17 cases the neuroendoscpe was advanced into third ventricle via the frontal horn and foramen of Monro,and third ventriculostomy was performed to achieve free communication between third ventricle and interpeduncular cistern. Fenestration of pellucid septum was performed in 3 cases. Results All procedures were successful and the fistula was unobstructed. 17 cases with two-side type hydrocephalus was treated with third ventriculostomy.The results of 15 cases （88.2%） were satisfactory and 2 cases （ 11.8%） inefficient, then ventricle-peritoneal shunt with neuroendoscope was performed and the result of the another 3 cases with one-side type hydrocephalus were treated with fenestration of pellucid septum was satisfactory. The general effective rate was 90.0%. Conclusion Because of convenience, less wound and efficiency, the neuroendoscopic operation should be the first choice for the treatment of hydrocephalus caused by hydrocephalus aqueduct obstruction.

关 键 词：神经内镜 第三脑室底造瘘术 梗阻性脑积水 

分 类 号：R651[医药卫生—外科学]