内窥镜辅助的显微神经外科手术

Endoscopey-assisted neurosurgery for intracranial operation

目的 探讨内窥镜辅助显微神经外科的临床应用价值。 方法 在包括颅内肿瘤、囊性病变、颅内动脉瘤、神经 血管压迫综合征、血肿及脑积水的 37例颅脑病变患者手术中使用神经内窥镜 ,分析内窥镜与显微手术配合的过程 (包括对脑组织、颅神经的暴露与保护 ,手术视野 ,手术时间等多方面 )。 结果 颅脑肿瘤组 15例 ,13例肿瘤全切 ,肿瘤全切率高 ,并发症少 ,其中桥脑小脑角肿瘤 11例 ,在肿瘤全切下面神经均得以保留 ;神经 血管压迫综合征 6例 ,手术效果良好 ;脑积水 6例 ,能够了解脑积水的确切原因 ;囊性病变 6例 ,内窥镜有助于在手术伊始及早知道病因及从关键部位开始处理 ;中风血肿 4例清除手术中使用内窥镜 ,与骨瓣开颅术比较 ,残留血肿少 ,手术时间短 ;此外内窥镜使手术视野更为直观、全面 ,亦不增加操作的复杂性。 结论 内窥镜辅助的显微神经外科手术有较大的优势 ,在不远的将来有可能成为神经外科标准手术方式之一。

Objective To investigate the value of endoscope assisted neurosurgery for intracranial operation. [WT5”HZ]Methods[WT5”BZ] 37 patients with intracranial lesions including tumors, aneurysms, cysts,hematomas, hydrocephylus and nerve vessel compression syndrome were treated with this method. Their results were compared to those of microsurgery and macrosurgery. The items analyzed included exposure and protection of brain tissue and cranial nerves, views of operation field, length of procedure etc. [WT5”HZ]Results[WT5”BZ] 15 patients with tumors, showe a high rate of complete removal but less complications. The 6th nerves of CPA tumors operation were preserved. Six cases of nerve vessel compression syndrome showed excellent therapeutic effects. In 8 cases of intraventricle lesions, using endoscope easily found tumor location and the cause of hydrocephylus. As to saccular diseases, endoscope was used to deal with the major location. In 4 cases of hematomas, less blot remained and the procedure shortened. Moreover the operation field was more clear and adeguate on the expenses of no more complexcity of the procedure. [WT5”HZ]Conclusions[WT5”BZ] Endoscope assisted microsurgery is helpful in intracranial operation. It might become a standard neuro operation in near future.