神经内镜治疗梗阻性脑积水30例  

Neuroendoscope for 30 patients with obstructive hydroceohalus

作　　者：陈淳[1] 徐荣华[1] 张杰[1] 邓发斌[1] 周宇[1] 李元斌[1] 刘跃辉[1] 王益红[1] 

机构地区：[1]成都市第六人民医院,四川成都610051

出　　处：《西部医学》2008年第6期1212-1213,共2页Medical Journal of West China

基　　金：四川省卫生厅科研基金项目(NO:030174)

摘　　要：目的探讨神经内镜在梗阻性脑积水治疗中的作用。方法采用德国蛇牌硬质神经内镜对30例患者行33次治疗，并经3～36个月随访，以对疗效进行评价。结果行第三脑室底造瘘术的20例患者中18例成功造瘘，2例三脑室底造瘘失败而改行内镜引导下V—P分流术，18例三脑室底造瘘患者15例效果满意，所有病例术后颅内高压疽状完全缓解，复查头部CT或MRI，扩大的脑室系统全部恢复正常，3例无效，改作内镜引导下的V—P分流术，疗效满意，对于丘脑肿瘤合并双侧室间孔堵塞性脑积水5例，在内镜下行透明中隔造瘘术，并同时行肿瘤部分切除活检＋V-P分流术，术后双侧脑室缩小，症状明显缓解。内镜下分流管取出调整术5例病人，术后患者脑室缩小，症状缓解。术后4例出现发热1～4天，无颅内感染发生。结论神经内镜治疗梗阻性脑积水是安全、经济、实用的微创手术方式，可推广应用。Objective To explore the value of endoscope for the obstructive hydroceohalus. Methods 30 patients were treated with snake rigid neuroendoscope and were followed up for 3-36 months. The clinical effect was analyzed. Result 18 （90. 9%） of 20 cases with the third ventriculostomy were successful and 2 cases were failed and then with endoscopic V-P shunt. ） cases succed, 12 failed and underwent. The effect of 15 （83.3%） of 18 cases with third ventriculostomy were satisfactory. The symptoms of intracranial hypertension were completely relieved after operatively. Conclusion Endoscopic third ventriculostomy is safe ,effective and minimally invasive to treat obstructive hydrocephalus.

关 键 词：神经内镜 脑积水 第三脑室底造痿术 透明中隔造瘘术 

分 类 号：R742.7[医药卫生—神经病学与精神病学]