中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2011年
25期
1731-1733
,共3页
詹升全%李昭杰%周东%林志俊%唐凯%林晓风%王鹏%舒航%周德祥%李炎稳%郭文龙%毛承亮
詹升全%李昭傑%週東%林誌俊%唐凱%林曉風%王鵬%舒航%週德祥%李炎穩%郭文龍%毛承亮
첨승전%리소걸%주동%림지준%당개%림효풍%왕붕%서항%주덕상%리염은%곽문룡%모승량
神经内窥镜%脑积水%脑室造口术
神經內窺鏡%腦積水%腦室造口術
신경내규경%뇌적수%뇌실조구술
Neuroendoscopes%Hydrocephalus%Ventriculostomy
目的 探讨神经内镜造瘘术在治疗颅内病变中的作用.方法 回顾性分析广东省人民医院神经外科1998年5月至2010年5月使用神经内镜造瘘术治疗的颅内病变的临床资料.选取具有代表性手术方式的病例共372例,手术包括神经内镜下第三脑室底造瘘术198例、神经内镜下第三脑室底造瘘加病变活检或切除术69例、透明隔造瘘术55例、脑室囊肿造瘘术50例.总结并分析其手术适应证的把握及手术效果.结果 成功行造瘘术369例,2例改行其他手术,活检术未成功1例.短期内症状缓解347例(93 3%),症状无缓解23例(6.2%),死亡2例(0.5%).术后半年第三脑室底造瘘术手术无效22例(9.5%),透明隔囊肿造瘘术无效23例(69.7%),脑室内囊肿造瘘术无效12例(26.7%).结论 神经内镜下第三脑室底造瘘术对于梗阻性脑积水疗效显著,但对于儿童须严格把握手术适应证;神经内镜造瘘术对于透明隔囊肿整体有效率不高,需严格把握手术适应证.
目的 探討神經內鏡造瘺術在治療顱內病變中的作用.方法 迴顧性分析廣東省人民醫院神經外科1998年5月至2010年5月使用神經內鏡造瘺術治療的顱內病變的臨床資料.選取具有代錶性手術方式的病例共372例,手術包括神經內鏡下第三腦室底造瘺術198例、神經內鏡下第三腦室底造瘺加病變活檢或切除術69例、透明隔造瘺術55例、腦室囊腫造瘺術50例.總結併分析其手術適應證的把握及手術效果.結果 成功行造瘺術369例,2例改行其他手術,活檢術未成功1例.短期內癥狀緩解347例(93 3%),癥狀無緩解23例(6.2%),死亡2例(0.5%).術後半年第三腦室底造瘺術手術無效22例(9.5%),透明隔囊腫造瘺術無效23例(69.7%),腦室內囊腫造瘺術無效12例(26.7%).結論 神經內鏡下第三腦室底造瘺術對于梗阻性腦積水療效顯著,但對于兒童鬚嚴格把握手術適應證;神經內鏡造瘺術對于透明隔囊腫整體有效率不高,需嚴格把握手術適應證.
목적 탐토신경내경조루술재치료로내병변중적작용.방법 회고성분석광동성인민의원신경외과1998년5월지2010년5월사용신경내경조루술치료적로내병변적림상자료.선취구유대표성수술방식적병례공372례,수술포괄신경내경하제삼뇌실저조루술198례、신경내경하제삼뇌실저조루가병변활검혹절제술69례、투명격조루술55례、뇌실낭종조루술50례.총결병분석기수술괄응증적파악급수술효과.결과 성공행조루술369례,2례개행기타수술,활검술미성공1례.단기내증상완해347례(93 3%),증상무완해23례(6.2%),사망2례(0.5%).술후반년제삼뇌실저조루술수술무효22례(9.5%),투명격낭종조루술무효23례(69.7%),뇌실내낭종조루술무효12례(26.7%).결론 신경내경하제삼뇌실저조루술대우경조성뇌적수료효현저,단대우인동수엄격파악수술괄응증;신경내경조루술대우투명격낭종정체유효솔불고,수엄격파악수술괄응증.
Objective To explore the application of neuroendoscopic treatment for intracranial lesions. Methods The clinic data of 372 patients with intracranial lesions, who underwent neuroendoscopic treatment at our department from May 1998 to May 2010, were reviewed retrospectively. Representative endoscopic treatments included endoscopic third ventriculostomy (ETV) (n=198), ETV & endoscopic biopsy (n=69) , neuroendoscopic ostomy for septum pellucidum fenestration (n=55) (for septum pellucidum cysts, n=37) and endoscopic cystoventriculostomy for ventricular cysts (n=50). Their surgical indications and clinical outcomes were summarized for analysis. Results ETV was performed successfully in 369 cases. Among them, 2 failed cases underwent other operations and endoscopic biopsy failed in 1case. Within a short post-operative period, the symptoms were resolved in 347 cases (93.3%) , showed no improvement in 23 cases (6.2%) and 2 died (0.5%). At Month 6 post-operation, a failure of ETV was detected in 22 cases (9.5%), a failure of neuroendoscopic ostomy for septum pellucidum cysts in 23(69.7%) and for ventricular cysts in 12 cases (26.7%). Conclusion ETV is effective in the treatment of obstructive hydrocephlus, but its indication should be strictly controlled for children. Effective rate of neuroendoscopic treatment for intracranial septum pellucidum cysts remains unsatisfactory so that its operative indication should be strictly controlled.
