神经内镜治疗颅内病变27例报告

Use of neuroendoscope in treating intracranial disease:a report of 27 cases

目的探讨神经内镜治疗或辅助治疗颅内病变。方法应用蛇牌硬直内镜对27例颅内病变进行治疗或辅助治疗,其中侧脑室蛛网膜囊肿7例;三脑室颅咽管瘤8例;三脑室脑囊虫病2例,丘脑胶质瘤3例;松果体区肿瘤2例(以上22例均合并单侧或双侧梗阻性脑积水),血管母细胞瘤2例;桥小脑角胆脂瘤3例。结果随访12～36个月,24例有效,3例死于肿瘤扩散,病变全部或部分切除,合并脑积水患者高颅压明显缓解,13例患者术后行伽玛刀治疗。术后无严重并发症。结论神经内镜适合治疗颅内病变合并脑积水,脑囊虫病,脑深部胆脂瘤,并可以辅助显微外科手术,并与伽玛刀结合治疗颅内肿瘤有它的独到优势,而且手术创伤小,安全、有效,值得推广。

Objective To investigate the clinic effect of the utilization of neuroendoscope to treat intracranial disease or as an assistant therapy.Methods Neuroendoseope（snake brand）was used in the treatment or as a assistant treatment of 27 patients with intracranial disease ,which including 7 cases of lateral ventricle arachnoid cyst ,g cases of third ventricle eraniopharyngioma ,2 eases of third ventricle cysticercosis,3 cases of thalamus ncurospongioma, 2 cases of tumors of pineal region（all of the 22 cases above combined with obstructive hydrocephalus in one side or both sides）, 2 cases of hemangiohlastoma and 3 cases of cerebellopontine angle margaritoma. Results The pathological changes resected in full or parthly by neuroendosope, and 13 patients underwent gamma knife later. All patients were followed up 12 to 36 months, 24 eases were cured, all of the eases with intraeranial hypertension obviously relieved, and 3 cases dead with tumor diffusion .There were no severe complications occurred. Conclusion Neurocndoseope would be an effective therapy to treat intracranial disease such as hydrocephalus, brain cystieercosis and margaritoma of the deep part brain, and it were be an effectively assistant method for mierosurgery, and also have predominance to treat intracranial tumor when combined with gamma knife. As neuroendo- scope have so many merits such as minimally invasion, safety and utility, it＇s worthy to be spreaded.