神经内窥镜在神经系统肿瘤手术中的应用  

Application of neuroendoscope in the operation of nervous system tumors

作　　者：章翔 章薇 毛星刚 薛小燕 ZHANG Xiang;ZHANG Wei;MAO Xinggang;XUE Xiaoyan(Neurosurgery Department of Xijing Hospital,Air Force Medical University,Xi'an,Shaanxi 710032,China;School of Medicine,Tsinghua University,Beijing 100084,China;Tsinghua IDG/McGovern Institute of Brain Science,Beijing 100084,China;Neurosurgery Department of Tsinghua Changgeng Hospital Affiliated to Tsinghua University,Beijing 102218,China;Neurosurgery Department of Beijing Children's Hospital Affiliated to Capital Medical University,Beijing 100045,China;Pharmacology Teaching and Research Office of the Department of Pharmacy,Air Force Medical University,Xi'an,Shaanxi 710032,China)

机构地区：[1]空军军医大学西京医院神经外科,陕西西安710032 [2]清华大学医学院,北京100084 [3]清华-IDG/麦戈文脑科学研究院,北京100084 [4]清华大学附属北京清华长庚医院神经外科,北京102218 [5]首都医科大学附属北京儿童医院神经外科,北京100045 [6]空军军医大学药学系药理学教研室,陕西西安710032

出　　处：《中华神经外科疾病研究杂志》2024年第6期1-7,共7页Chinese Journal of Neurosurgical Disease Research

基　　金：国家自然科学基金资助项目(82273978,81972359);空军军医大学临床医学+药学研究中心科研课题(LHJJ2023-YX19)。

摘　　要：颅脑和脊髓中的原发或继发性神经系统肿瘤,其治疗一直是神经外科学领域的重要课题。随着微创手术技术的不断发展,神经内窥镜作为一种新兴的微创手术工具,逐渐在神经系统肿瘤手术中展现出其独特的优势。神经内窥镜在颅脑手术中的应用主要集中在颅底肿瘤和垂体腺瘤的切除之中。通过内窥镜可以实现经鼻-蝶窦入路的微创手术,大大减少了传统开颅手术所带来的创伤,提升了患者术后康复的速度。神经内窥镜手术要求术者要具有良好的空间感知能力和精细操作技巧,特别是在手术视角与操作协调方面,需要经过大量的模拟训练和实际操作经验的积累。在操作过程中,需要术者时刻关注周围神经结构,避免造成不必要的损伤。在脊柱和脊髓手术中,神经内窥镜的应用也越来越广泛。建立工作通道和神经保护技术是内窥镜脊柱手术中的关键步骤。内窥镜辅助下的椎管内肿瘤切除和椎间盘突出症手术,因其微创性和精准性,故疗效很满意。在临床实践中,神经内窥镜的微创性和快速恢复是其最大的优势之一,与传统开颅和开刀手术相比,内窥镜手术的切口更小,术后并发症的发生率很低,患者的住院和康复时间也大为缩短。因此,受到了同行专家的广泛关注和认可,这种技术值得大范围的推广和应用。The treatment of primary or secondary nervous system tumors in the brain and spinal cord has always been an important topic in the field of neurosurgery.With the continuous development of minimally invasive surgical techniques,neuroendoscope,as a new minimally invasive surgical tool,has gradually shown its unique advantages in the operation of nervous system tumors.The application of neuroendoscope in craniocerebral surgery mainly focuses on the resection of skull base tumor and pituitary adenoma.Endoscopic transnasal and sphenoid sinus approach can achieve minimally invasive surgery,which greatly reduces the trauma caused by traditional craniotomy and improves the speed of postoperative rehabilitation of patients.Neuroendoscopic surgery requires the surgeon to have good spatial perception ability and fine operation skills,especially in the aspects of surgical perspective and operation coordination,which means that neuroendoscopic surgeons must go through a lot of simulation training and practical experience accumulation.In the process of operation,the surgeon must pay attention to the peripheral nerve structure at all times to avoid unnecessary damage.Neuroendoscopy is also being used more and more widely in spinal and spinal cord surgery.Establishing working pathways and neuroprotective techniques are key steps in endoscopic spinal surgery.Endoscopyassisted resection of intraspinal tumor and intervertebral disc herniation has satisfactory results due to its microtrauma and precision.In clinical practice,the minimally invasive nature and rapid recovery of neuroendoscopy is one of its biggest advantages.Compared with traditional craniotomy and surgical surgery,endoscopic surgery has a smaller incision,a lower incidence of postoperative complications,and a greatly shortened hospital stay and rehabilitation time for patients.Therefore,it has attracted wide concern and recognition among the peer experts,and is worthy of large-scale promotion and application.

关 键 词：神经系统肿瘤 颅脑与脊柱 神经内窥镜 操作技巧 肿瘤全切或部分切除 随访 预后 

分 类 号：R73[医药卫生—肿瘤]