第三脑室底造瘘治疗梗阻性脑积水

目的：探讨对梗阻性脑积水患者采用在神经内窥镜下进行第三脑室底造瘘的手术方法。分析手术成功与失败的原因,方法：对21例不同原因造成的梗阻性脑积水患者进行了23次神经内视镜下的第三脑室底造瘘手术。结果：随访1-33个月,平均19个月,显效15例,有效2例,4例无效患者改行V-P分流术,2例接受2次造瘘;手术并发症包括颅内感染2例,严重硬膜下积液1例,暂时性脑疝1例,暂时性动眼神经麻痹1例,中脑及丘脑出血各1例,无死亡病例,结论：神经内窥镜下的第三脑室底造瘘对治疗梗阻性脑积水是一种安全、有效的手术方法,但为了提高手术疗效,减少手术并发症,应采用良好的手术器械、熟练掌握手术方法,选择适当手术患者。

Endoscopic third ventriculostomy in treating obstructive hydrocephalus

Objective:To explore the usefulness of third ventriculostomy in treating obstructive hydrocephalus with neuroendoscopy,analysis the reason of successful or failed.Methods:23 endoscopic third ventriculostomy(ETV)was be done in 21 patients with obstructive hydrocephalus caused by different reasons.Results:Follow-up from1to33 months and 19months on the average.Excellent results in 15 patients,improvements in 2 patients and no change in 4 patients,4 failed patients received V-P shunt subsequently,two patients received two times ETV;complications included 2 infections, fluid collect in subdural,1 temporary cerebral hernia caused by hematoma occupied third ventricle,1 oculomotor palsy.I temporary hemiplegia caused by thalamus bleeding,1disturbance of consciousness caused by midbrain bleeding,no death case.Conclusions:ETV is a saf eand effective operation method, but,for the reason to raise the sefety and reduce the cpmplication,must to use a good instrument,grasped operatioonal skill well and to select the promising candidates.