【摘要】 目的探讨神经内镜在分流故障后脑积水治疗中的应用价值。方法2005年6月～2008年7月,对52例脑积水分流故障患者进行内镜治疗。结果36例患者在内镜下成功取出了分流管并摆脱了分流依赖,占69%,其中1例术后出现脑室内出血,经脑室外引流治愈,1例术后合并一过性尿崩,经药物对症治疗治愈,无其他手术并发症出现;2例摆脱了分流依赖但因分流管脑室端已长入脑组织内且有血管包绕未能成功取出脑室端管,占4%;14例经过内镜下脑室冲洗、分流管取出、脑室外引流改善脑室环境后需再次分流,未能摆脱分流依赖,占27%。结论脑积水分流故障后可通过内镜探查明确原因,部分患者内镜下治疗后可摆脱分流依赖。更多还原

【Abstract】 ObjectiveTo study the application of neuro-endoscope to the treatment of patients with shunt malfunction. MethodsA total of 52 patients with shunt malfunction were treated with neuro-endoscopic procedures from June 2005 to July 2008. ResultsIn the 52 cases, 36 ( 69%) were free from shunt after endoscopic procedure. Among them, no other operative complications appeared except for 1 case with postoperative intraventricular hemorrhage who was cured by ventricular out-drainage and 1 case with transient diabetes insipidus who was cured with medicine. Two cases (2/52, 4%) were free from shunt after endoscopic procedure but the shunting catheter could not be dislodged due to blood vessels or brain tissue surrounding. However,14 cases (14/52, 27%) could not be free from shunt and had to have a re-shunt after the ventricular circumstances got improved by endoscopic ventricular irrigation, out-drainage, and shunting catheter dislodgment. ConclusionEndoscopic ventricular inspection can define the cause of malfunction in hydrocephalus. Some patients can be free from shunt after endoscopic procedures.更多还原