内窥镜手术治疗脑积水及颅内囊性占位病灶的临床分析

Endoscopic surgery for cystic lesion hydrocephalus and intracranial lesions

目的 探讨神经内窥镜治疗梗阻性脑积水及颅内囊性占位病灶的临床特点.方法 回顾性分析该院2005年2月～2008年2月应用神经内窥镜技术治疗颅内病变患者48例临床资料,其中梗阻性脑积水26例,蛛网膜囊肿12例,透明隔囊肿6例,鞍上巨大囊肿3例,鞍上囊性颅咽管瘤1例.术后随访24个月,观察患者并发症及治疗效果.结果 并发症：发热3例,硬膜下积液2例,脑室出血1例,并发症发生率仅12.5%;疗效：42例有效,有效率高达87.5%,6例无效（脑积水5例,鞍上巨大囊肿1例）.结论 神经内窥镜治疗颅内病变具有创伤小、直观、并发症少、有效率高等优点,但要严格掌握手术适应证.

Aim To explore clinical features of endoscopic treatment of obstructive hydrocephalus and nerve intracranial lesions cystic lesion.Methods Retrospective analysis was made in 48 patients with intracranial lesions admitted from February 2005 to February 2008,including obstructive hydrocephalus 26 cases,arachnoid cysts 12 cases,transparent insulation cyst 6 cases,saddle huge cyst 3 cases,saddle cystic cranial pharynx article 1 case.With 24-month follow-up,patients were observed in complications and therapeutic effect.Results The complications included calorific 3 cases,subdural effusion 2 cases,ventricle bleeding 1 case,with a morbidity of only 12.5%.Treatments in 42 patients were effective,efficient rate as high as 87.5%,6 cases invalid（hydrocephalus in 5 cases,saddle huge cyst in 1 case）.Conclusion Endoscopic treatment of intracranial lesions has small trauma,intuitiveness,fewer complications,and the advantages of high efficiency,but surgical indications should be controlled strictly.