CAJ | 학술논문

目的探讨应用神经内镜治疗第四脑室出口闭锁(FVOO)的疗效.方法 30例患者行第三脑室底造瘘术(ETV).术中观察第三脑室底和基底池的情况.经扩张的导水管行第四脑室探查及出口膜性闭锁穿刺造瘘术.术后脑脊液电影成像( Cine-MR)检查评价导水管、第四脑室出口和第三脑室底造瘘口处的流量和流速变化.结果本组28例成功行ETV.6例经扩大的中脑导水管行第四脑室探查,其中2例行出口膜性闭锁穿刺造瘘术.随访时间0.5 ～4.0年.手术成功率是78.6％( 22/28).结论 ETV是治疗第四脑室出口闭锁的有效方法.第四脑室出口膜性闭锁穿刺造瘘术的疗效尚需进一步观察.
목적 탐토응용신경내경치료제사뇌실출구폐쇄(FVOO)적료효.방법 30례환자행제삼뇌실저조루술(ETV).술중관찰제삼뇌실저화기저지적정황.경확장적도수관행제사뇌실탐사급출구막성폐쇄천자조루술.술후뇌척액전영성상( Cine-MR)검사평개도수관、제사뇌실출구화제삼뇌실저조루구처적류량화류속변화.결과 본조28례성공행ETV.6례경확대적중뇌도수관행제사뇌실탐사,기중2례행출구막성폐쇄천자조루술.수방시간0.5 ～4.0년.수술성공솔시78.6％( 22/28).결론 ETV시치료제사뇌실출구폐쇄적유효방법.제사뇌실출구막성폐쇄천자조루술적료효상수진일보관찰.
Objective To explore the therapeutic efficacies of endoscope for fourth ventricular outlet obstruction(FVOO).Methods Endoscopic third ventriculostomy (ETV) was performed for 30 cases.The circumstances of third ventricular floor and basal cistern were observed and recorded intraoperatively.Meanwhile the fourth ventricular exploration and fistulation were performed across enlarged aqueduct.And the velocity and flow rate of aqueduct,fourth ventricular outlet and stoma were evaluated postoperatively with Cine-MR (magnetic resonance).Results Standard ETV was performed successfully in 28 patients.Fourth ventricular exploration ( n =6 ) and outlet membrane fistulation ( n =2 ) were carried out.The mean follow-up period was 2.3 years ( range:0.5 - 4.0).The overall success rate was 78.6％.Conclusion ETV is a viable therapeutic option for FVO0 patients.The therapeutic effects of outlet membrane fistulation require further observations.