摘要
目的探讨软性神经内镜在神经外科的应用价值。方法应用光学纤维神经内镜和电子软性神经内镜,配合软性内镜专用手术器械单独或辅助显微外科手术治疗各种神经外科疾病228例。结果对63例慢性硬膜下血肿采用内镜下单纯钻孔冲洗术治疗,除早期1例术后血肿复发接受2次手术外,其余患者均一次治愈。10例侧脑室及三脑室后部肿瘤患者采用内镜下肿瘤活检、全切或部分切除,有8例明确病理诊断后改用其他治疗方式治疗。78例梗阻性脑积水患者在内镜下进行第三脑室底造瘘术,所有患者均获得成功造瘘,无1例造成副损伤。对19例因脑脊液吸收障碍导致的脑积水患者进行脉络丛烧灼术,其中13例仅单纯行脉络丛烧灼术,除1例单纯烧灼后颅压下降不明显、术后2周再行脑室-腹腔分流外,其余均获得满意疗效。内镜下打通脑室内多发分隔（感染或出血后）配合透明隔造瘘3例,均获成功。内镜下治疗颅内蛛网膜囊肿16例,手术效果满意。此外,完成内镜辅助下手术39例,效果满意。结论软性神经内镜有其独特的应用优势,和硬性神经内镜配合使用可以大大提高神经内镜在神经外科微创手术中的应用范围,值得推广。
Objective To study the application of flexible neuroendoscope in neurosurgery. Methods 228 cases with all kinds of neurosurgical diseases were treated by endoscopic neurosurgery （EN） or endoscopic assisted microneurosurgery （EAM） based on both optical fiber neuroendoscope or electrical flexible endoscope and special instruments for flexible endoscope. Results 63 cases with chronic subdural hematoma were cured by single burr hole drainage with endoscope besides only 1 early case combined with hemotoma recurrence who accept the second operation. Biopsy, total or partial remove of tumor were completed with endoscope in 10 cases with tumor in lateral or third ventricnlar, other therapeutics were given to 8 cases after the pathological diagnose were definite. All 78 cases with obstructive hydrocephalus obtained successful endoscopic third ventricnlostomy with no side damage. 19 cases with hydrocephalus due to cerebral spinal fluid absorption disturbance got satisfactory effect with choroid plexus cauterization except only 1 case need V-P shunt 2 weeks postoperation. Arachnoid cyst were cured with endoscope in 16 cases. Endoscope assisted microneurosurgery was finished in 39 cases, which can improve the operation effect by avoiding the excessive pull to brain tissue. Conclusions Flexible neuroendoscope is worth to spread due to its special superiority to improve the applicable scope of neuroendoscope in minimally invasive neurosurgery, especially cooperated with rigid neuroendoscope.
出处
《中华神经外科杂志》
CSCD
北大核心
2007年第3期169-171,共3页
Chinese Journal of Neurosurgery
关键词
神经内镜
弹性软镜
临床应用
Neuroendoscopy
Flexible Endoscop
Clinical application
