脑积水外科治疗方法的改进与临床应用  

Clinical improvement and application of surgical methods for hydrocephlus

作　　者：张庆林[1] 刘玉光[2] 宋涛[1] 孙金龙[1] 孙炜[1] 刘延鹏[1] 

机构地区：[1]山东大学第二医院神经外科,济南250012 [2]山东大学齐鲁医院神经外科

出　　处：《中华神经外科杂志》2004年第2期163-166,共4页Chinese Journal of Neurosurgery

摘　　要：目的对脑积水治疗的手术器械和外科治疗方法从七个方面进行创新和改进,并用于临床。方法(1)1964～1965年与新华医疗器械厂合作研制成功快速细孔钻颅器。(2)同年用于临床行术前、术后脑室体外引流急性脑积水的抢救和脑室造影。(3)1972年首先采用快速细孔钻颅脑室体外引流术加腰穿加压注液治疗急性枕大孔疝。(4)1973开展三脑室内肿瘤手术切除肿瘤的同时,一期手术行侧脑室-幕上池分流术。(5)1996年开展了电视腹腔镜下“套管式”侧脑室-肝膈间隙分流术治疗脑积水。(6)1998～2001年将新术式与常规侧脑室-腹腔分流术进行了对比研究。(7)1998～2002年应用脑室镜治疗脑积水及脑室镜与腹腔镜联合应用治疗脑积水。结果上述研究用于临床,长者近四十年,取得了显著的治疗效果并已广泛应用。结论上述七个方面各有其适应证,符合微侵袭原则,长期实践证明其安全性和实用性,丰富扩展了脑积水的治疗技术与方法。Objective The surgical methods and apparatus for hydrocephlus were improved and innovated in the seven sides and used clinically. Methods (1)Xihua Medical Apparatus Company cooperated with us created successfully rapid small hole cranio-puncture apparatus between 1964 and 1965.(2)At the same time, the apparatuses were used clinically to perform ventricular drainage for acute hydrocephlus and ventriculography pre-operatively and past-operatively.(3)In 1972, we firstly developed the ventricular drainage by a rapid small hole cranio-puncture associated with lumbar puncture and pressurizely injecting fluid for acute tonsillar hernia.(4)Removal of the third ventricular tumors together with ventriculo-supratentorial cistern shunt were developed in 1973. (5)the ″casing-tube″ ventriculo -hepato-diaphramatic space shunt for hydrocephalus under aparoscope was done in 1996.(6)We compared the treatment effect of ventriculo-hepato-diaphramatic space shunt for hydrocephalus under aparoscope with that of routine ventriculo-peritoneal shunt for hydrocephalus from 1998 to 2001.(7)Between 1998 and 2002, we treated hydrocephalus by ventriculoscope and ventriculoscope associated with aparoscope. Results The marked treatment effect and broad practice were attained after clinical application of the treatment methods above-mentioned, whose the longest contribution time was almost 40 years. Conclusions The indications varied with the surgical treatment methods above-mentioned, which accords with the principle of minimal invasion and enriches and extends the treatment techniques and methods. It has been proved that they were safe and practical by long-term practice.

关 键 词：脑积水 治疗 临床应用 外科手术 

分 类 号：R651.1[医药卫生—外科学]