[1]甘武,周东,詹升全,等.神经内镜下第三脑室底造瘘术治疗梗阻性脑积水的长期疗效分析（附142例报道）[J].中国临床神经外科杂志,2023,28(10):609-612.[doi:10.13798/j.issn.1009-153X.2023.10.001]
　GAN Wu,ZHOU Dong,ZHAN Sheng-quan,et al.Long-term outcomes of endoscopic third ventriculostomy for patients with obstructive hydrocephalus: report of 142 cases[J].,2023,28(10):609-612.[doi:10.13798/j.issn.1009-153X.2023.10.001]
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神经内镜下第三脑室底造瘘术治疗梗阻性脑积水的长期疗效分析（附142例报道）()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
28
期数:
2023年10期
页码:
609-612
栏目:
论著
出版日期:
2023-10-31

文章信息/Info

Title:
Long-term outcomes of endoscopic third ventriculostomy for patients with obstructive hydrocephalus: report of 142 cases
文章编号:
1009-153X（2023）10-0609-04
作者:
甘武; 周东; 詹升全; 林晓风; 郭文龙
510080广州，广东省人民医院（广东省医学科学院）神经外科（甘武、周东、詹升全、林晓风、郭文龙）
Author(s):
GAN Wu;  ZHOU Dong;  ZHAN Sheng-quan;  LIN Xiao-feng;  GUO Wen-long
Department of Neurosurgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
关键词:
梗阻性脑积水; 神经内镜; 第三脑室底造瘘术; 长期疗效
Keywords:
Obstructive hydrocephalus;  Endoscopic third ventriculostomy;  Long-term outcomes
分类号:
R 742.7; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2023.10.001
文献标志码:
A
摘要:
目的 探讨神经内镜下第三脑室底造瘘术（ETV）治疗梗阻性脑积水的长期随访效果。方法 回顾性分析2010年1月至2018年8月EVT治疗的142例梗阻性脑积水的临床资料。结果 142例均顺利完成手术，造瘘口大小2~10 mm，平均5 mm。术后CT显示脑积水均缓解，其中119例（83.8%）症状逐步改善，23例无明显改善。术后发生颅内出血26例（18.3%），保守治疗后恢复；发生颅内感染6例（4.2%），药物治疗后恢复；未见明显偏瘫、意识障碍、尿崩、明显记忆力障碍、基底动脉损伤、动眼神经损伤情况。失访10例，其余132例随访1~147个月，平均89.7个月，其中118例（89.4%）随访超过36个月。首次ETV失败10例（7.6%），发生时间在术后1~37个月，其中8例行CT检查后改行VPS，1例再次行ETV，1例术后5个月因急性脑积水行脑室外引流术后出现硬膜下血肿而死亡。结论 ETV是治疗梗阻性脑积水的首选方式，长期有效率高，失败多发生于术后3年内，注意随访，根据病情可再次ETV或VPS解决脑积水。
Abstract:
Objective To investigate the long-term outcomes of endoscopic third ventriculostomy (ETV) in the treatment of patients with obstructive hydrocephalus. Methods The clinical data of 142 patients with obstructive hydrocephalus treated with EVT from January 2010 to August 2018 were retrospectively analyzed. Results All patients successfully completed the operation, the size of the stoma was 2~10 mm (average, 5 mm). CT showed that the hydrocephalus was relieved in all patients after operation, and the symptoms were gradually improved in 119 patients (83.8%) and were not in 23 patients. Intracranial hemorrhage occurred in 26 patients (18.3%) who were recovered after conservative treatment. Intracranial infection occurred in 6 patients (4.2%) who were recovered after drug treatment. There was no obvious hemiplegia, disturbance of consciousness, diabetes insipidus, obvious memory impairment, basilar artery injury, oculomotor nerve injury. Ten patients were lost to follow-up, and the other 132 patients were followed up for 1~147 months (mean, 89.7 months), of which 118 patients (89.4%) were followed up for more than 36 months. The first ETV failure occurred in 10 patients (7.6%), and the failure time ranged from 1 month to 37 months after operation. Of the failed 10 patients, 8 patients underwent VPS after CT examination, 1 patient underwent ETV again, and 1 patient died due to subdural hematoma after external ventricular drainage for acute hydrocephalus. Conclusions ETV is the first choice for the treatment of obstructive hydrocephalus, with high long-term effective rate and failure occurring more frequently within 3 years after surgery. Pay attention to follow-up, and ETV or VPS can be used to solve hydrocephalus again according to the condition.

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备注/Memo

备注/Memo:
（2023-01-02收稿，2023-08-06修回）
基金项目：广州市科技计划项目（202102020650）；广东省医学科学技术研究基金（A2021210）：
通讯作者：周　东，E-mail：zhoudong5413@163.com
更新日期/Last Update: 2023-10-31