【作者】 宁波； 宁蕾； 杨远城； 梁一鸣； 林之琪； 李储忠； 毕智勇； 宗绪毅；

【机构】 暨南大学医学院附属广州红十字会医院神经外科； 泰山医学院附属医院； 暨南大学医学院附属广州红十字会医院病案室； 首都医科大学附属北京天坛医院神经外科；

【摘要】 目的总结神经内镜技术治疗合并脑积水脑囊虫病的特点和方法。方法对首都医科大学附属北京天坛医院神经外科2007年1月～2017年1月26例合并脑积水脑囊虫病内镜手术病历资料进行回顾性分析。其中单纯行ETV3例,ETV+内镜下取虫21例,内镜下取虫+脑室腹腔分流术2例,25例患者术后1月开始药物驱虫治疗。结果本组无死亡病例,术后并发症包括颅内感染2例(7.7%)、头痛6例(23.1%)、癫痫发作4例(15.4%)、一过性的动眼神经麻痹2例(7.7%)、硬膜下积液1例发生(3.8%)。出院后24例(92.3%)病例经12月～60月随访(平均36.5月),临床症状、体征改善21例(87.5%),无变化2例,疾病进展需再次手术治疗1例。结论合并脑积水脑囊虫病首选神经内镜手术治疗,可对脑室系统及基底池探查取虫,手术创伤小,恢复快。更多还原

【Abstract】 Objective To discuss the effect of neuro-endoscopic management of neurocysticercosis combined with hydrocephalus(NCH).Method From January 2007 to January 2017,the clinical data of 26 NCH patients received endoscopic surgeries were collected and analyzed.Results Endoscopic third ventriculostomy(ETV) and cyst removed were performed in 21 cases.Three cases only received ETV while 2 cases received cyst removed and ventriculo-peritoneal shunt.No patient was dead.Intracranial infection occurred in 2 cases and headache in 6 cases,seizures in 4 cases,transient oculomotor paralyses in 2 cases and subdural collection of fluid in 1 case.After a follow-up of 24 patients for 12-60 months(average 36.5 months),clinical symptomatic improvement in 23 cases(88.5%),no change in 2 cases,deterioration in 1 cases.The cerebral-spinal fluid film on MR imaging showed the CSF flowed through the fistula very well in 23 cases.Conclusions Neuro-endoscopic management is the first choice for NCH because it can make the whole ventricular exploration and cyst resection at the same time with lower injury and easier recovery.更多还原