本文選題：腦積水 + 神經內鏡　； 參考：《山西醫科大學》2005年碩士論文

【摘要】：近年來,隨著神經內鏡的發展,其在神經外科的應用越來越廣,但由于神經內鏡自身的局限性,目前多被用于腦室系統的診斷和治療中,為了更好地將神經內鏡應用于腦室疾病的治療中,我們開展了神經內鏡經額手術入路的側腦室和三腦室解剖結構的研究。 目的:(1)為梗阻性腦積水患者行神經內鏡下三腦室造瘺術提供可靠的應用解剖學資料。(2)探討梗阻性腦積水患者腦室內解剖結構的病理變化特點。(3)為臨床開展神經內鏡經額入路手術提供應用解剖學資料。 方法:18 例腦積水患者,其中 13 例梗阻性腦積水和 5 例交通性腦積水手術患者,觀察神經內鏡下三腦室和側腦室的解剖特點和重要的解剖標志。 結果:(1)神經內鏡下腦室內重要的解剖路標有:脈絡叢、室間孔、丘紋靜脈、隔靜脈、乳頭體、導水管開口等。(2)神經內鏡下腦積水可見腦室系統均有不同程度的擴大,室間孔均明顯擴大,部分病例除腦室均勻擴大外,腦室結構常有一些解剖變異和病理改變。(3)經額入路神經內鏡觀察范圍大,能清楚地觀察到側腦室的額角、體部、枕角的廣泛區域,側腦室內的重要解剖標志和神經血管結構觀察清楚,進入三腦室后,可以觀察到前達漏斗隱窩后至后連合的廣泛區域。 結論:(1)神經內鏡下腦室內觀察到的重要解剖路標是室間孔處的 Y形結構。(2)長期的腦積水和持續的腦室內壓力增高能導致腦室內的解剖異常改變,它們對完成神經內鏡下三腦室底造瘺術可能是重要的,要求在三腦室底造瘺術中給予特別的關注。(3)經額手術入路神經內鏡觀察范圍大,是腦室內神經內鏡手術最常見的手術入路,神經內鏡經此入路可以完成多種手術。
[Abstract]:In recent years, with the development of neuroendoscopy, its application in neurosurgery is more and more extensive. However, because of the limitation of endoscopy itself, it has been widely used in the diagnosis and treatment of ventricular system. In order to better use neuroendoscopy in the treatment of ventricular diseases, we studied the anatomical structure of lateral ventricle and third ventricle via endoscopic frontal approach. Objective: to provide reliable applied anatomical data for the patients with obstructive hydrocephalus undergoing endoscopic third ventriculostomy. (2) to explore the pathological changes of the intraventricular anatomy in patients with obstructive hydrocephalus. Endoscopic frontal approach provides applied anatomical data. Methods 18 patients with hydrocephalus, including 13 patients with obstructive hydrocephalus and 5 patients with communicating hydrocephalus, were studied for the anatomic features and important anatomic markers of the third ventricle and lateral ventricle under neuroendoscope. Results the important anatomical signs of ventricle under neuroendoscope were: choroid plexus, interventricular foramen, papillary vein, septal vein, papillary body, aqueduct orifice, etc.) the ventricular system was enlarged in varying degrees in hydrocephalus under endoscope. All the interventricular foramen were enlarged obviously. In some cases, there were some anatomical variations and pathological changes in the structure of the ventricle except for the even enlargement of the ventricle. The endoscopic observation of the lateral ventricle via frontal approach was very wide, and the frontal horn and body parts of the lateral ventricle could be clearly observed. The extensive area of occipital angle, the important anatomic mark of lateral ventricle and the structure of nerve and blood vessel were observed clearly. After entering the third ventricle, a wide range of areas from anterior to posterior funnel recess to posterior conjunctions could be observed. Conclusion one of the important anatomical signs observed under neuroendoscope is Y-shaped structure at interventricular foramen.) Long-term hydrocephalus and continuous increase of intraventricular pressure can lead to abnormal anatomic changes in the ventricle. They may be important for the completion of third ventricular fundus fistula under neuroendoscopy, requiring special attention during the operation of the third ventricle floor fistula. Endoscopy is the most common approach to intraventricular neuroendoscopy, which can perform multiple operations.
【學位授予單位】：山西醫科大學
【學位級別】：碩士
【學位授予年份】：2005
【分類號】：R651;R322

【參考文獻】

相關期刊論文 前10條

1 周勁松,劉守勛,戈治理;內窺鏡神經外科學[J];國外醫學.神經病學神經外科學分冊;1993年02期

2 李俊,牛光明,秦尚振,李監松,馬廉亭,薛德麟,徐國政,龔杰,李愛冰;幕上腦室的神經內鏡應用解剖學研究[J];臨床外科雜志;2004年11期

3 林志俊,詹升全,許作奎,林曉風,曾少健;球囊擴張導管在神經內窺鏡手術中的應用[J];中國臨床神經外科雜志;2000年04期

4 孟輝 ,馮華 ,王憲榮 ,張禮均 ,高伯元 ,朱剛;經神經內鏡手術治療腦積水[J];中國內鏡雜志;2002年10期

5 張亞卓,王忠誠,高鮮紅,朱安林,劉丕楠,莊言;神經內窺鏡技術的臨床應用[J];中華神經外科雜志;2000年01期

6 詹升全,李昭杰,林志俊,許作奎,林曉風,周東,舒航,唐凱;神經內鏡治療腦積水[J];中華神經外科雜志;2001年04期

7 高鮮紅,何樂,張亞卓,劉丕楠;側腦室、三腦室神經內鏡應用解剖[J];中華神經外科雜志;2001年04期

8 孟輝,馮華,王憲榮,高伯元,朱剛,林江凱,崔高宇,李飛,張禮均;第三腦室底造瘺術治療梗阻性腦積水與分流術的療效比較[J];中華神經外科雜志;2003年06期

9 王志潮,丁學華,廖建春,秦時強,朱杭軍;內窺鏡下側腦室前角手術入路的應用解剖[J];中國臨床解剖學雜志;2003年05期

10 陳志剛;內窺鏡第三腦室造瘺術[J];中國微侵襲神經外科雜志;2003年01期

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