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目的 :小儿梗阻性脑积水的常用治疗方法为脑室 -腹腔分流术 ,该手术并发症高。神经内镜间下第三脑室底脚间池造瘘术是一种治疗脑积水的新方法 ,克服了分流术的缺点。方法 :对 2 1例导水管狭窄性脑积水患儿 ,取侧脑室额角入路 ,神经内镜通过室间孔进入第三脑室底部 ,于第三脑室底与脚间池之间造一瘘孔。结果 :18例近期疗效满意 ,3例改行脑室 -腹腔分流术 ,无严重并发症。结论 :该手术具有以下优点 :微创手术 ;手术在直视下进行 ,增加了安全性 ;脑脊液通过瘘孔进入生理性的循环 ;避免了体内置管的各种并发症 ;部分禁忌脑室 -腹腔分流术者亦适合该治疗。
OBJECTIVE: Common treatment for pediatric obstructive hydrocephalus is ventricular-peritoneal shunt, which has high complications. Neuroendoscopic third ventricle footcispitopeostomy is a new method for the treatment of hydrocephalus, to overcome the shortcomings of shunt. Methods: Twenty-one children with aqueduct of stenosis caused by hydronephrosis were treated by forehead approach of the lateral ventricle. Neuroendoscopy entered the bottom of the third ventricle through the interventricular foramen and created a fistula between the third ventricle and the foot pool . Results: 18 cases of recent satisfactory results, 3 cases diverted ventricle - peritoneal shunt, no serious complications. Conclusion: This procedure has the following advantages: minimally invasive surgery; surgery under direct vision, increased safety; cerebrospinal fluid into the physiological circulation through the fistula; to avoid a variety of complications of the body tube; part of the contraindication ventricle - abdominal cavity Shunt also suitable for this treatment.