神经内镜治疗小儿梗阻性脑积水

目的：小儿梗阻性脑积水的常用治疗方法为脑室－腹腔分流术，该手术并发症高。神经内镜间下第三脑室底脚间池造瘘术是一种治疗脑积水的新方法，克服了分流术的缺点。方法：对２１例导水管狭窄性脑积水患者，取侧脑室顺角入路，神经内镜通过室间孔进入第三脑室底部，于第三脑底与脚间池之间造一瘘孔。结果：１８例近期疗铲满意，３例改行脑室－腹腔分流术，无严重并发症。结论：该手术具有以下优点，微创手术；手术在直视下进行，增另

NERVE ENDOSCOPY TREATMENT OF INFANTILE OCCLUSIVE HYDROCEPHALY

Objective: Conventional treatment of occlusive hydrocephalus is V-P shunt, but it has many complications. Endoscopic third ventriculostomy (ETV) is a new way to treat occlusive hydroceohalus, it override the shortcoming of V-P shunt. Methods: ETVs were performed in 21 cases with aqueductal stenosis. Endoscope was advanced through a standard coronal burr and frontal cortex into the lateral ventricle then through the foramen of Monro into the third ventricle, perforated in the floor of the third ventricle. Result: The operative results were excellence in 18 cases. 3 cases have additional shunt. No severe complication. Conclusions: The advantage of ETV were as following: 1. Minimally invasive approach. 2. It's safe and direct control. 3. CSF go through stoma into normal circulation. 4. Avoid complications of shunt. 5. Can be performed in some cases that were contradiction to shunt.