应用神经内镜行三脑室底造瘘术治疗梗阻性脑积水

目的探讨应用神经内镜行三脑室底造瘘在治疗梗阻性脑积水中手术方法、效果和影响手术效果的因素、手术后并发症的的预防。方法回顾性分析55例行神经内镜治疗梗阻性脑积水的临床资料。结果55例患者中54例造瘘成功,1例因三脑室底布满血管网不能造瘘,50例效果良好,4例患者无效,于造瘘后3个月内又行脑室腹腔分流术。手术后发生硬膜下积液8例,1例患者4个月后发生慢性硬膜下血肿又行钻孔外引流术。头皮下积液8例,手术后发热15例。癫痫1例,硬膜外出血1例。结论神经内镜行三脑室底造瘘是安全有效的,效果满意。

Endoscopic third ventriculostomy in treatment of obstructive hydrocephalus

Objective To explore the effects, influencing factors, and complications of endoscopic third ventriculostomy for obstructive hydrocephalus. Methods The clinical data of 55 patients with obstructive hydrocephalus, 29 males and 26 females, aged 18.4 (6 months~59 years), who underwent endoscopic third ventriculostomy were analyzed retrospectively. Results Endoscopic third ventriculostomy was performed successfully in 54 patients, and one patient failed to undergo endoscopic third ventriculostomy because of densely distributed blood vessels at the bottom of the third ventricle. Satisfying post-operative results were obtained in 50 cases and no effect was seen in 4 cases that underwent V-P shunt 3 months later. Subdural hygroma occurred in 4 of the 55 cases, subscalp hydrops in 8 cases, post-operative fever in 4 cases, epilepsy in 1 case, and epidural hemorrhage in 1 case. Conclusion Endoscopic third ventriculostomy is safe and effective in the treatment of obstructive hydrocephalus.