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目的 :对小儿导水管狭窄性脑积水的一种新的治疗方法进行探讨。方法 :对 34例导水管狭窄性脑积水的患儿 ,采用神经内窥镜取侧脑室额角入路 ,通过室间孔进入第三脑室内 ,于第三脑室底部与脚间池之间造一瘘孔进行治疗。结果 :2 8例 (82 .4% )近期疗效满意 ,其中优 14例 ,良 14例。CT或MR检查见 14例脑室缩小 ;14例脑室无继续增大 ,脑沟较术前明显 ,蛛网膜下腔增宽。 6例无效 ,改行脑室—腹腔分流术。无严重并发症。结论 :神经内窥镜下第三脑室底脚间池造瘘术具有微创、安全及脑脊液通过瘘孔进入生理性的循环等优点 ,可作为导水管狭窄性脑积水的首选治疗方法。
Objective: To investigate a new treatment method for pediatric aqueduct stenosis hydrocephalus. Methods: Thirty-four pediatric patients with aqueduct of stenosis caused by hydrocephalus were treated with neuroendoscopy to approach the forehead of the lateral ventricle. The third ventricle entered the third ventricle through the interventricular foramen and was made between the bottom of the third ventricle and the footwell Fistula hole for treatment. Results: Twenty-eight cases (82.4%) had satisfactory short-term results, of which 14 were excellent and 14 were good. CT or MR examination showed 14 cases of ventricular contractions; 14 cases of ventricular enlargement was not obvious, the sulcus was significantly preoperative, subarachnoid widened. Six cases were ineffective, switch to ventricle - peritoneal shunt. No serious complications. Conclusion: The endoscopic ventriculostomy under the neuroendoscope has the advantages of minimally invasive, safe and physiological circulation of cerebrospinal fluid through the fistula, which can be used as the first choice for the treatment of stenosis of aqueduct.