分流失败小儿脑积水的神经内镜治疗  

Neuroendoscopic surgery for hydrocephalus in children after failed V-P shunt

作　　者：吕务军[1] 关健伟[1] 李在雨[2] 李钢[1] 樊伟强[1] 王海东[1] 吴耀晨[1] 

机构地区：[1]广东省深圳市第五人民医院脑病中心,518001 [2]大连医学院第二附属医院神经外科,大连116000

出　　处：《中华神经医学杂志》2006年第11期1168-1169,共2页Chinese Journal of Neuromedicine

摘　　要：目的探讨小儿分流调整失败后应用神经内镜技术治疗的方法和体会。方法应用单纯内镜手术方法,对6例脑室-腹腔分流调整失败患儿进行分流管调整术,脉络丛烧灼术,第三脑室造瘘术。结果5例先天性梗阻性脑积水、1例松果体区占位行脑室腹腔分流术后发生堵塞患儿,应用神经内镜技术进行治疗,手术过程顺利;3例患者有不同程度发热,持续时间2～7d;随访6个月至24个月病情明显好转,脑积水改善,分流管通畅。结论神经内镜对脑室-腹腔分流调整失败患儿进行治疗,具有微创、安全、准确、并发症少、经济等优点,是神经外科较好的治疗方法。Objective To discuss the method and experience of applying neuroendoscope to cure the hydrocephalic children who have had a failed ventriculoperitoneal （V-P） shunt operation. Methods In 6 hydrocephalic children who failed in V-P shunt operation, neuroendoscopic surgery was performed for shunt tube adjustment, choroids plexus cauterization and third ventriculostomy. Results Five cases due to congenital obstructive dydrocephalus and 1 cases due to space-occupying lesion at conarium underwent the V-P shum but failed, so followed by neuroendoscopic surgery. The procedure was done well. After that, 3 cases had a fever in different degree that lasted for 2～7 d. During the 6～24 month follow-up, the children had a better condition of ameliorated hydrocephalus and unobstructed shunt tubes. Conclusion With the advantages such as less wound, security, accuracy, less complications and cost, the neuroendoscopic surgery should be an important strategy for the treatment of the children who have been failed in V-P shunt operation.

关 键 词：神经内镜 脑积水 第三脑室底造瘘术 小儿 

分 类 号：R742.7[医药卫生—神经病学与精神病学]