神经内镜技术的临床应用

目的探讨神经内镜的临床应用。方法应用内镜手术治疗各种颅内病变22例，其中透明隔囊肿3例，脑积水2例，鞍上囊肿1例，单侧室间孔阻塞1例，垂体瘤13例，脑脊液鼻漏1例，桥小脑角胆脂瘤1例。结果用单纯内镜手术治疗7例颅内囊性病变及脑积水，6例症状改善，1例脑积水改行分流手术。用内镜控制的显微神经外科治疗垂体瘤13例，全切10例，次全切3例；脑脊鼻漏修补1例，效果良好。用内镜辅助显微神经外科全切1例桥小脑胆脂瘤。22例病人中2例出现一过性尿崩，1例出现一过性脑脊液鼻漏，1例出现视力恶化，经治疗后均愈。结论内镜治疗颅内囊性病变，手术副损伤小，疗效确切；内镜下经鼻腔切除垂体瘤，微创、安全、有效；神经内镜辅助显微外科可提高手术疗效。

Clinical Application of Neuroendoscopic Techniques

Objective To explore the clinical application of neuroendoscopic techniques to neurosurgery. Methods Twenty-two patients with different intracranial diseases were treated by neuroendoscopic techniques including endoscopic neurosurgery, endoscope-controlled microneurosurgery and endoscope-assisted microneurosurgery. Of 22 patients, 3 suffered from symptomatic septum pellucidum cyst, 2 hydrocephalus, 1 suprasellar cysts, 1 obstruction of Monro foramen, 13 pituitary adenomas, 1 cerebrospinal rhinorrhea and 1 cholesteatoma. Results Of 13 patients with pituitary adenomas, 10 underwent total resection of the tumors and 3 subtotal resection. One case of cerebrospinal rhinorrhea was cured. One case of cholesteatoma was totally resected. Of the other 7 patients, 6 improved in symptoms and 1 with hydrocephalus underwent shunt after the neuroendoscopic operation. The complication included transient diabetes insipidus in 2 patients, transient cerebrospinal rhinorrhea in 1 and transient visual diterioration in 1. Condusions The neuroendoscopic operation is a safe and effective method of treatment of the patients with intracranial cysts or pituitary adenomas. The endoscope-assisted microneurosurgery can improve the quality of neurosurgery.