经神经内镜手术治疗脑积水

NEUROENDOSCOPIC APPROACH TO HYDROCEPHALUS

目的 :探讨神经内镜治疗脑积水的适应症、方法及技巧。方法 :回顾性总结了经神经内镜手术治疗的脑积水 5 2例 ,手术方法包括三脑室底造瘘术 ,透明膈造瘘术 ,脉络丛烧灼术及内镜下置分流管。结果 :随访 2月～4 8月。 16例原发性导水管狭窄性脑积水 15例疗效满意 ;12例肿瘤压迫导水管性脑积水 10例疗效满意 ;7例单侧室间孔堵塞性脑积水均有效。 3月后复查CT提示脑室缩小 30例。 17例交通性脑积水术后症状均有明显改善。结论 :神经内镜手术治疗脑积水微创、安全、疗效好 ,适用于所有类型的脑积水 ;三脑室底造瘘术应作为梗阻性脑积水的首选方法 ;

Objective:To determine the indications, approach and technique of neuroendoscopic surgery for hydrocephalus.Methods:Fifty-two cases with hydrocephalus were endoscopic managed. The operations include endoscopic third ventriculostomy, fenestration of septum pellucidum, choroids plexus coagulation and catheter laid by endoscope.Results:Follow-up period was 2～48 months. The effective cases was 15 in 16 of hydrocephalus caused by primary aqueductal stenosis, 10 in 12 of hydrocephalus caused by external tumor compression of the aqueduct, 7 in 7 of unilatal hydrocephalus caused by foramen of Monro obstructed, 17 in 17 of communicating hydrocephalus.Conclusion:Endoscopic neurosurgery can be recommended as a minimum invasiveness, safe, improve curative effect and less operative complications to hydrocephalus, and its indications include all types of hydrocephalus. Endoscopic third ventriculostomy should be the first selection of noncommunicating hydrocephalus,the chance of catheter obstructed can be decreased in the treatment of communicating hydrocephalus using catheter laid by endoscope.