第三脑室底造瘘术治疗梗阻性脑积水与分流术的疗效比较

目的 比较梗阻性脑积水的两种手术方法的疗效及并发症。方法 采用经神经内镜第三脑室底造瘘术治疗梗阻性脑积水35例，脑室腹腔分流术治疗梗5且性脑积水63例。结果 造瘘组：平均用时35min，症状缓解34例(97.1％)，复发1例(2．9％)，并发症3例(8.6％)，为非感染性发热；分流组：平均用时78min，症状缓解63例(100％)，复发16例(25．4％)，并发症18例(28．6％)，为分流管堵塞、感染、颅内血肿及分流管外露等。两组均无死亡。结论 经神经内镜第三脑室底造瘘术治疗梗5且性脑积水较脑室腹腔分流术的疗效相当，并发症及复发率明显降低，手术时间缩短，应作为梗阻性脑积水的首选治疗方法。

Endoscopic third ventriculostomy versus shunt operation in obstructive hydrocephalus

Objective To compare the postoperative effect and complications of two methods for obstructive hydrocephalus.Methods 35patients who underwent endoscopic third ventriculostomy and63patients who underwent ventriculo-peritoneal shunt operation for obstructive hydrocephalus were re viewed.Results In ventriculostomy group,the medial operating time was35minutes,34(97.1%)improved and1(2.9%)recurred,3(8.6%)had fever.In shunt group,the medial operating time was78minutes,63(100%)improved and16(25.4%)recurred,18(28.6%)had complications included tube blocked,infection or intracranial hematoma.Conclusions Endoscopic third ventriculostomy has equal effect compared with ventriculo-peritoneal shunt operation for obstructive hydrocephalus,and it can decrease the complications,recurrence rate and operating time.So ventriculostomy should be the first selection of obstructive hydrocephalus.[