CAJ | 학술논문

目的探讨第三脑室肿瘤合并脑积水经神经内镜治疗的方法和手术技巧.方法分析北京世纪坛医院神经外科收治的4例第三脑室肿瘤合并脑积水患者(前侧部肿瘤2例,底部肿瘤1例,后部肿瘤1例)的临床资料、影像学表现,结合相关文献总结手术经验与技巧.结果 4例患者中3例采用单纯神经内镜手术,1例采用神经内镜辅助显微镜下手术.术后患者临床症状明显改善,无严重并发症及死亡病例.随访3～18月,患者复查头部MRI显示肿瘤无复发,脑积水均有不同程度改善.结论神经内镜导航下可直达肿瘤所在位置,又可减少不必要的损伤,切除肿瘤同时可解除梗阻性脑积水,重建脑脊液循环,是一种治疗第三脑室肿瘤合并脑积水安全有效的手术方法.
목적 탐토제삼뇌실종류합병뇌적수경신경내경치료적방법화수술기교.방법 분석북경세기단의원신경외과수치적4례제삼뇌실종류합병뇌적수환자(전측부종류2례,저부종류1례,후부종류1례)적림상자료、영상학표현,결합상관문헌총결수술경험여기교.결과 4례환자중3례채용단순신경내경수술,1례채용신경내경보조현미경하수술.술후환자림상증상명현개선,무엄중병발증급사망병례.수방3～18월,환자복사두부MRI현시종류무복발,뇌적수균유불동정도개선.결론 신경내경도항하가직체종류소재위치,우가감소불필요적손상,절제종류동시가해제경조성뇌적수,중건뇌척액순배,시일충치료제삼뇌실종류합병뇌적수안전유효적수술방법.
Objective To explore the treatment methods and surgical techniques of the third ventricle tumor combined with hydrocephalus under neuroendoscope. Methods The clinical data and imaging findings of 4 patients with third ventricle tumor combined with hydrocephalus, treated with surgery under neuroendoscopy, were retrospectively analyzed; and related literatures were reviewed to conclude the surgical experiences and skills. Results Three of the 4 patients were performed surgery only by neuroendoscopy, and 1 by neuroendoscopic auxiliary microscope for the tumor complete resection. The clinical symptoms improved obviously after the surgery, and no significant complications and no dead case were noted.We followed up the 4 patients for 3-18 months; MRI showed that the tumor did not relapse and the hydrocephalus got improvement. Conclusion Endoscopic navigation can help to directly reach the locations of third ventricle tumor and decrease the unnecessary damage, which enjoys its advantages in tumor resection,relieving obstructive hydrocephalus and rebuilding the cerebrospinal fluid circulation, indicating that surgery under neuroendoscope is a safe, effective and minimally invasive method.