摘要
目的 研究神经内镜治疗脑积水的适应证、效果和并发症.方法 采用神经内镜治疗脑积水30例,其中神经内镜三脑室造瘘术（ETV）22例,神经内镜透明膈造瘘术2例,因室间孔狭小或视野不清改行脑室-腹腔分流术5例.分析其临床和影像学结果,总结其效果、适应证和并发症.结果 行ETV的22例术后颅内压210～240 mmH2O,平均（226±28） mmH2O.并发脑膜炎2例,发热4例, 1例切口愈合不良, 4例ETV术后并发头皮下少量积液.出血3例,无死亡和永久后遗症.结论 对于因导水管狭窄、后颅窝和中脑占位引起的梗阻性脑积水患者ETV有很好的效果.慎重选择造瘘部位和器械对于避免出血等严重并发症有重要意义.
Objective To study the results, indications and complications of the endoscope in the operations for hydrocephalus. Methods 30 patients with hydrocephalus have been treated with neuroendoscope. 22were treated by ETV, 2 were treated by pellucid septum fistulization. 5 were treated by V-P shunt because the Monroe foramens were narrow or the operative visual field was not clear. Their clinical and radiological data was analyzed. The curative effect, indications and operative technique were summarized. Results The ICP was 210～240 mmH2O（226 mmH2O± 28 mmH2O） after operation in 22 patients treated by ETV. The complications were meningitis（2）, fever（4）, wound healing by second intention（1 ）, bleeding（3）, subscalp fluid collection（4）. There were not permanent sequelas in the survivals. Conclusion ETV is an effective method treating obstructive hydrocephalus caused by aqueduct stenosis and occupying lesions in posterior cranial fossa and midbrain. It is very important to select right puncture site and right insertion instrument for preventing postoperative hemorrhage and complications.
出处
《华中医学杂志》
CAS
2006年第3期174-176,共3页
Central China Medical Journal
基金
湖北省卫生科研基金项目(NX200420)
河南省卫生厅创新人才项目(2004107044)
关键词
脑积水
神经内镜三脑室造瘘术
适应证
并发症
Hydrocephalus Endoscopio third ventriculostomy Indication Complication
