神经内窥镜临床应用的初步经验：附19例报告

近年来，神经内窥镜在临床已广泛使用。作者应用神经内窥镜清除基底节血肿１０例，皮层下血肿６例，行脑室内、脑室旁和颞叶表面蛛网膜囊肿造瘘术各１例。颅骨钻孔位置选择距病灶最近，并可贯穿病变全程。１０例基底节血肿清除和１例脑室内蛛网膜囊肿造瘘术通过ＣＴ立体定向导入内窥镜，其余病例均徒手导入内镜。有１１例血肿患者术后４８小时以内行ＣＴ复查，９例残余血肿２０％～３０％以下。３例蛛网膜囊肿患者术后症状有所缓解，２例术后１个月ＣＴ复查造瘘口清晰可见，１例体积缩小２０％～３０％。本组病例中无手术直接并发症，体现了内窥镜手术侵袭性小的优点。作者还就内镜术的麻醉选择、操作细节问题进行了详细的讨论。

Primary clinical experience of neuroendoscopy:report of 19 cases

10 cases of basal ganglion and 6 of subcortical hematoma were evacuated. One case of temporal and 2 cases of para- and intra-ventricle arachnoid cyst were fenestrated towards the cistern or lateral ventricle. Burred holes were near the lesion, through which endoscope should run. We guided the endoscope to the target by stereotatic equipment in 10 cases of basal ganglion hematoma and 1 case of ventricle arachnoid cyst, and introduced endoscope by free-hand in other cases. Hematoma group: CT reexamination within 48 hours showed that the residual hematoma was less than 20%-30% in 9 of 11 cases. Cyst group: symptoms of all cases of arachnoid cysts were alleviated after intervention. CT after a month showed that fenestration entrance could be seen clearly in 2 cases. The cyst reduced 20%-30% in 1 case. There were no direct complications in the group. It was shown that operation by endoscope is minimal invasive and little complicated.