神经内窥镜技术在颅内占位病变患者中的应用

The application of endoscopy technology treating patients with intracranial disease

目的探讨神经内窥镜技术在颅内占位病变患者中的应用价值。方法对自2009年1月至2011年12月就诊于新乡医学院第一附属医院的42例颅内占位病变患者应用内窥镜技术手术治疗，其中采用单纯神经内窥镜手术行透明隔囊肿造瘘11例，脑室内血肿清除10例，神经内窥镜辅助的显微神经外科手术行听神经瘤切除7例，神经内窥镜控制的神经外科手术行脑内血肿清除14例，术后观察临床疗效并行格拉斯哥预后评分（GOS）评价。全部患者术后门诊随访3～8个月。结果10例透明隔囊肿造瘘术后3～8个月患者头痛头晕消失，1例减轻；10例脑室内出血患者术后24h复查CT示侧脑室枕脚少许积血，尿激酶灌注，72h复查积血消失；6例听神经瘤患者术后3—8个月恢复良好，听力基本正常，1例患者有所改善；14例脑内血肿患者术后48h复查CT示均无残余血肿。结论神经内窥镜技术治疗神经外科常见基本微创小，安全有效，具有广阔应用前景。

Objective To explore the endoscopy technology in neurosurgery and summarizes the clinical experience after application. Methods Fourty two patients with intracranial disease who were treated in the First Affiliated Hospital of Xinxiang Medical University from January 2009 to December 2011 accepted endoscopic surgery, among them 11 eases accepted pure neural endoscopic surgery assisted cyst transparent colostomy, 10 cases accepted indoor hematoma clear, acoustic neuromas resection was performed in 7 patients by microscopic neural surgery, 14 cases accepted neural endoscopic control nerve surgery to relieve brain hematoma, postoperative clinical curative effect and Glasgow outcome scale（GOS） were observed. All the patients were followed up for 3 to 8 months after operation. Results Headache and dizziness disappeared in 10 cases who received transparent colostomy, 1 case eased; 10 cases intraventricular hemorrhage patients lateral ventricle pillow feet had a little hemorrhage, after treatment hemorrhage disappeared for 72 hours; 6 cases of patients with acoustic neuromas postoperative recovery were good and got the basic normal hearing, 1 patient was improved; 14 cases of cerebral patients within 48 hours after the hematoma found no residual hematoma. Conclusions The endoscopy techniques for the treatment of neurosurgery is minimally invasive , safe and effective, it has the broad application prospect.