【摘要】 目的分析神经内镜对第三脑室后部区域肿瘤的诊断和治疗价值。方法回顾性分析110例第三脑室后部区域肿瘤的病例资料。术前病人均继发非交通性脑积水,均行神经内镜手术治疗。结果神经内镜下取得组织标本99例(99/110,90%),最终获得明确病理结果 89例(89/110,80.9%)。行第三脑室底造瘘术(ETV) 106例(106/110,96.4%),其中术后脑积水缓解100例(100/106,94.3%),无效需改行外引流或脑室-腹腔分流术6例(6/106,5.7%)。内镜下全切肿瘤2例(2/110,1.8%),术后脑积水均缓解。术中出血改行脑室外引流2例(2/110,1.8%)。术后出现并发症12例(12/110,10.9%),经处理后好转,无手术相关死亡。术后随访1年或以上,接受ETV的病例,术后远期需进一步行脑室-腹腔分流术或其他分流手术25例。结论对第三脑室后部区域肿瘤,神经内镜可通过活检或切除肿瘤组织来明确诊断,以便于指导下一步治疗。神经内镜还可安全、有效治疗肿瘤相关的非交通性脑积水,具有重要临床价值。更多还原

【Abstract】 Objective To analyze the value of neuroendoscopy for tumors in the posterior third ventricular region. Methods The clinical data of 110 patients with tumors in the posterior region of the third ventricle were analyzed retrospectively. All the patients were non-communicating hydrocephalus before operation, and underwent neuroendoscopic surgery. Results The specimens were obtained in 99 cases(99/110, 90%) by neuroendoscopy, and pathological results were obtained in 89 cases(89/110, 80.9%). There was endoscopic third ventriculostomy(ETV) in 106 patients(106/110, 96.4%), including postoperative hydrocephalus relief in 100 cases(100/110, 94.3%), and external ventricular drainage or ventriculo-peritoneal shunt in 6(6/106, 5.7%). Total tumor resection was achieved in 2(2/110, 1.8%) by neuroendoscopy, and postoperative hydrocephalus was relieved. The external ventricular drainage was performed due to bleeding in 2 patients(2/110, 1.8%). Complications were seen in 12 cases(12/110, 10.9%), which were improved after treatment. There was no death. The patients were followed up for 1 year or more, 25 cases of ETV were needed ventriculo-peritoneal shunt or other shunt surgery in the long-term. Conclusions For the tumor in the posterior region of the third ventricle, neuroendoscopy can confirm the diagnosis and guide the treatment by biopsy or resection of the tumor tissue. Neuroendoscopy can also safely and effectively treat tumor-related non-communicating hydrocephalus, which has important clinical value.更多还原