神经内镜下导水管成形术治疗导水管梗阻性脑积水

目的 探讨软性神经内镜下导水管成形术治疗导水管梗阻性脑积水的应用价值.方法 2007年2月至2008年4月,应用电子软性神经内镜对16例导水管梗阻性脑积水在软性内镜下分别经额或枕下入路行导水管成形术.结果 16例患者导水管均成功再通,术后高颅压症状缓解,无意识障碍、动眼神经麻痹等导水管成形术相关并发症出现.12例术后6个月磁共振电影成像检查显示中脑导水管脑脊液最大流速较术前增加(2.18±0.34)cm/s,最大流量较术前增加(0.22±0.07)ml/s.结论 软性内镜下导水管成形术对治疗导水管狭窄或膜性梗阻导致的脑积水是一种安全有效的方法 ,但应严格掌握手术适应证.

Endoscopic aqueductoplasty in the treatment of aqueductal obstructive hydrocephalus

Objective To study the application of endoscopic aqueductoplasty for the treatment of aqueductal obstructive hydrocephalus. Methods 16 cases of aqueductal obstructive hydrocephalus were treated with endoscopic aqueductoplasty under flexible neuron-endoscope in trans-frontal or stiboccipital approach respectively from Febrary 2007 to April 2008. Results All 16 patients had a sucessful aqueductoplasty with no complications related to aqueductoplasty such as disturbance of consciousness or oculomotor nerve paresis. The symptom of intracranial hypertension disappeared postoperatively. The maximal velocity of cerebrospinal fluid flow through aqueduct increased (2.18±0.34) cm/s and the maximal flux increased (0. 22±0. 07) ml/s detected by using cine phase-contrast magnetic resonance imaging 6 months postoperation in 12 cases. Conclusion Endoscopic aqueductoplasty with flexible neuron-endoscope is a safe and effective method for the treatment of obstructive hydrocephalus due to aqueductal stenosis or aqueductal membranous obstruction, but the operative indication should be obeyed strictly.