神经内镜手术治疗颅内疾病48例分析

Analysis of endoscopic neurosurgery for intracranial diseases (a report of 48 cases)

目的 :探讨神经内镜手术治疗颅内疾病的作用。方法 :应用神经内镜手术治疗48例颅内疾病。结果 :经随访 3～ 36个月。 1 2例脑积水 ,其中 8例行第三脑室底脚间池造瘘术 ,术后 7例有效 ,有效率 87.5 % ,4例行脉络丛凝固术 ,术后 3例有效 ,有效率为 75 %。6例透明隔囊肿行囊肿 -脑室造瘘术 ,术后均有效。9例蛛网膜囊肿 ,其中 6例行囊肿 -脑池造瘘及部分囊壁切除术 ,术后均有效 ,另 3例未完成内镜手术。 1 8例慢性硬膜下血肿 ,其中 6例行内镜下残留血肿清除及部分内包膜切除术 ,术后均有效 ,另 1 2例未完成内镜手术。 3例脑内囊性肿瘤 ,1例行内镜瘤结节切除 ,另 2例未完成内镜手术。结论 :神经内镜手术是治疗颅内囊性疾病的一种微创新技术 ,在侧脑室内囊性病变的治疗中有独特的优势 ,在脑浅表囊性病变中有一定的治疗价值 。

Objective:To investigate the effect of endoscopic neurosurgery for intracranial diseases.Methods: There were 48 patients with intracranial diseases undergoing endoscopic neurosurgery. Results: Follow-up period was 3～36 manths. The effective rates were 87.5% (7 of 8 patients) with the third ventricuulostomy,75% in 3 of 4 communicating hydrocephalus by the choroid plexus coagulation,and 100% in cases of cystoventrculosmy of septum pellucidum cysts.6 cases with intracranial arachnoid cysts by the cystocisernostomy and cyst partial resection were all effective. 3 cases with intracranial arachnoid cysts can't undego endoscopic neurosurgery. 6 cases with chronic subdrual hematoma (CSH)underwent hematoma evacuation.12 cases CHS can't undergo endoscopic neurosurgery. One case with intrabrain cystic tumor underwent nodule uesection.2 cases with intrabrain tumors can't undergo endoscopic neurosurgery. Concluson: Endoscopic neurosurgery is a minimally invasive technique for indracranial cystic diseases.It has special effect in treatment of intraventrceular cystic lesions,and it has certain effect in treatment of superficial brain cystic lesions, and it has assistant effect in treatment of deep intrabrain cystic tumors.