摘要目的 通过分析脑室镜辅助下5种手术方式的疗效,探讨脑室镜在儿童脑积水手术中的应用价值. 方法 新疆医科大学第二附属医院神经外科自2009年8月至2014年5月分别采用5种脑室镜辅助手术方式(第三脑室造瘘术、第三脑室造瘘术+脑室-腹腔分流术、第三脑室造瘘术+脉络丛电灼术、脑室镜辅助下脑室-腹腔分流术、透明隔造瘘术+脑室腹腔分流术)治疗88例脑积水患儿,分析其疗效、预后及并发症情况. 结果 本组88例脑积水患儿经脑室镜-辅助手术治疗后,84例术后早期显效或有效,早期总有效率达95.45％.术后早期并发症78例次,均在1～～2周后恢复;晚期并发症18例(20.45％),其中再次行脑室-腹腔分流术14例(15.9％). 结论 脑室镜技术应用于儿童脑积水的治疗,可以使治疗方案个体化,提高手术成功率,减少远期并发症及二次手术的发生率,值得在临床上推广.

abstractsObjective To investigate the clinical efficacies of five kinds of neuroendoscopy assisted operation mode to discuss the clinical application of neuroendoscopy in the treatment of hydrocephalus in children.Methods Eighty-eight children with hydrocephalus,admitted to our hospital from August 2009 to May 2014,were treated by five kinds of neuroendoscopy assisted operation modes,which included endoscopic third ventriculostomy,endoscopic third ventriculostomy+ventricuIar-peritoneal shunt,endoscopic third ventriculostomy+choroid plexus cauterization,neuroendoscopy assisted ventricuIar-peritoneal shunt,and septum pellucidum colostomy,endoscopic septum pellucidotomy+ventricuIar-peritoneal shunt.The clinical efficacy,prognosis and complications of patients after being treated by these five kinds of operation modes were analyzed retrospectively.Results Eighty-four patients were effective or significantly effective at early stage after operation,with an overall response rate reaching to 95.45％.There were 78 times early complications,all of whom get well after one or two weeks.The late complications rate was 20.45％ (n=18),including 14 children (15.9％) performed repeat ventricuIar-peritoneal shunt.Conclusion Neurocndoscopy is applied to the treatment of children with hydrocephalus,which can make individualized treatment,improve the success rate of surgery,and reduce the incidence of late complications and secondary surgery,therefore,it is worth popularizing in clinic.