神经内镜在经颅治疗脑室相关深部肿瘤手术中的应用  

Application of neuroendoscopy in transcranial treatment of ventricle-related deep-seated tumors

作　　者：张鑫海 王晓澍[1] 杨刚[1] 钟东[1] 夏海坚[1] 霍钢[1] ZHANG Xinhai;WANG Xiaoshu;YANG Gang;ZHONG Dong;XIA Haijian;HUO Gang(Department of Neurosurgery,the First Affiliated Hospital of Chongqing Medical University,Chongqing,400016,China)

机构地区：[1]重庆医科大学附属第一医院神经外科,重庆400016

出　　处：《第三军医大学学报》2021年第5期376-382,共7页Journal of Third Military Medical University

摘　　要：目的探讨神经内镜在经颅治疗脑室相关深部肿瘤手术中的应用。方法回顾性分析本院2016年1月至2019年3月利用神经内镜及其辅助技术治疗21例脑室相关的深部实质性肿瘤患者的临床资料,评价其手术全切率、术后并发症及神经功能情况。结果15例患者肿瘤全切除,6例患者肿瘤次全切除。术后3例颅内感染,1例新发脑积水并再次手术,1例癫痫发作,3例皮下积液,无严重血肿水肿并发症;术后3例颅神经功能障碍改善,3例肌力下降症状改善,无神经功能障碍加重病例。21例患者随访18~36个月,其中全切组均未发现肿瘤复发,次全切组有2例肿瘤复发并再次手术。结论神经内镜在经颅治疗脑室相关深部肿瘤手术中可提供良好的术区可视化效果,有助于重建脑脊液循环,结合术中辅助工具的使用,为肿瘤的切除效果和手术安全性提供保证。Objective To explore the application of neuroendoscopy in transcranial treatment of ventricle-related deep-seated tumors.Methods We retrospectively analyzed the clinical data of 21 patients with ventricle-related deep-seated tumors treated with neuroendoscopy and its auxiliary technologies in our hospital from January 2016 to March 2019,and evaluated their total surgical resection rate,incidence of postoperative complications and neurological function.Results The tumors of 15 patients achieved total resection,and the tumors of 6 patients achieved subtotal resection.After operation,3 cases experienced intracranial infection,1 case had new hydrocephalus and underwent secondary operation,1 case presented epileptic seizure,and 3 cases manifested with subcutaneous effusion,but no complications such as severe hematoma and edema occurred.During the 18~36 months’follow-up,no tumor recurrence was observed in the total resection group,and 2 cases in the subtotal resection group experienced tumor recurrence and operation again.Conclusion Neuroendoscopy has a good visualization effect in the operation area and is helpful for the reconstruction of the cerebrospinal fluid circulation in transcranial treatment of ventricle-related deep tumors.Combined with the use of intraoperative auxiliary tools,neuroendoscopy provides a guarantee for the efficiency of tumor resection and the safety of surgery.

关 键 词：神经内镜 脑室相关深部肿瘤 手术治疗 

分 类 号：R730.56[医药卫生—肿瘤] R739.41[医药卫生—临床医学]