半导体激光配合神经内窥镜手术治疗小儿脑积水

Curative effects of endoscopic neurosurgery combined with semicondudor laser on children with hydrocephalus

目的 探讨微创神经外科技术在治疗脑积水中的应用。方法 应用半导体激光配合神经内窥镜对32例脑积水患儿 ,其中 15例梗阻性脑积水行第三脑室底造瘘术 ,11例交通性脑积水行脉络丛电灼凝固术 ,6例室间孔闭塞性脑积水行透明隔造瘘术。结果 随访 31例 ,随访时间 6个月～ 1年 ,头部动态CT或MRI复查 ,2 9例脑积水明显好转 ,2例出现脑积水加重 ,改用内窥镜辅助下脑室 腹腔分流术 (V P术 ) ,症状改善。术后并硬膜外血肿、脑室内少量出血各 1例 ,无感染、心肺功能异常等其他并发症。结论 半导体激光配合神经内窥镜技术治疗脑积水 ,创伤小 ,安全 ,术后并发症少 。

Objective To investigate the techniques and methods of minimally invasive neurosurgery on treatment pediatric hydrocephalus. Methods Thirty-two patients with hydrocephalus were treated by endoscopic neurosurgery assisted semiconductor laser. Among them,15 cases with obstructive hydrocephalus treated by fistulization through the third ventricle of cerebrum,11 cases with communicating hydrocephalus treated by choroids plexus coagulation, and 6 cases with interventricular foramen treated by fistulization of pellucid septum. Results Thirty-one cases have been followed up for 6-12 months. Through head CT/MRI dynamic observation, 29 cases were improved distinctly, but 2 cases were deteriorative, then changing V-P shunt assisted endoscopic neurosurgery symptoms improved. After operation, 1 case of epidural hematoma and 1 case of ventricular hemorrhage supervened,there were no infection,no cardio-pulmonary function abnormity and other complications. Conclusion It is safe and effective to treat pediatric hydrocephalus by endoscopic neurosurgery assisted semiconductor laser, and has less trauma and less complications.