神经内镜治疗颅内病变手术适应证探讨

Indications of neuroendoscopic surgery for intracranial diseases

目的探讨神经内镜在治疗颅内病变中的作用及手术适应证的选择。方法对386例神经内镜手术治疗颅内病变患者的临床资料进行回顾性研究，并对神经内镜手术方法的选择、术后疗效及优缺点进行分析。结果本组所有患者术后随访6～12月，临床治愈340例，症状好转40例，症状改善不明显5例，死亡1例。影像学复查颅内占位性病变285例中，全切除259例，次全切除26例，病变复发7例；脑积水101例中，脑室恢复至正常水平82例，脑室明显回缩18例，脑室回缩不明显1例。结论采用神经内镜治疗颅内病变，如果能严格掌握手术适应证，则疗效满意。

Objective To investigate clinical effect and indications ofneuroendoscopic surgery for treatment of intracranial diseases. Methods A total of 386 cases treated with neuroendoscopic surgeries were analyzedd retrospectively in regard advantages and disadvantages of neuroendoscopy. to the surgical approaches, treatment outcomes, Results In the 386 cases, clinical cure was achieved in 340 cases and symptomatic improvement in 40 cases; 5 cases failed to respond to the treatment, and death occurred in 1 case during the follow-up for 6-12 months. Postoperative radiography demonstrated intracranial space-occupying lesions in 285 cases, for which total resection was achieved in 259 cases and subtotal resection in 26 cases with neuroendoscopic surgery, and relapse occurred in 7 cases. Hydrocephalus occurred in 101 cases. Cerebral ventricle recovery was found in 82 cases, and in 18 cases the ventricular expansion was obviously reduced; ventricular expansion remained unchanged in 1 case after the treatment. Conclusions With careful evaluation of the surgical indications, neuroendoscopic surgeries can achieve satisfactory effects for treatment of intracranial diseases.