神经内镜在颅内肿瘤锁孔显微手术中的应用

Use of neuroendoscope in intracranial tumor microneurosurgery through a keyhole approach

目的探讨内镜辅助下锁孔入路显微手术治疗颅内肿瘤的意义及方法。方法应用神经内镜辅助下锁孔入路显微手术治疗颅内肿瘤30例。在显微镜下尽可能切除可见肿瘤部分,再用神经内镜辅助寻找残余肿瘤并切除。结果肿瘤全切除22例,次全切除5例,3例颅内动脉瘤成功夹闭。2例垂体腺瘤患者术后出现一过性多尿,经对症治疗均于术后1周恢复正常;1例胆质瘤患者术后发生无菌性脑膜炎,经对症治疗2周后痊愈。本组无一例死亡,无脑出血、颈内动脉损伤和视神经损伤发生。结论神经内镜辅助下锁孔显微手术治疗颅内肿瘤,有助于提高肿瘤全切除率,减少手术创伤。

Objective To study the techniques for treating the intracranial tumor. Methods Through a keyhole approach with endoscope-assisted micro-neurosurgery, 30 patients with intracranial tumor were treated. With microneurosurgery, larger part of tumor was resected, then under neuroendo-scope remains of tumors were found out and removed. Results Tumors were totally removed in 22 patients,subtotally removed in 5. In three patients cerebral aneurysm was clipped successfully. Two patients with pituitary adenoma had temporay diuresis and one patient non-bacteria meningitis, and after two weeks treatment all recovered. There was no-mortality in 41 patients, no cerebral hemorrhage, optic nerve injury, internal carotid injury, and other complications occurred. Conclusion Endo- scope-assisted microneurosurgery through a keyhole approach can increase the total-resection rate for tumors, reduce the trauma of operation and postoperative reaction.