脑积水治疗过程中内窥镜下脑室解剖结构研究

发布时间：2018-06-16 13:20

本文选题：脑积水 + 神经内镜　；参考：《山西医科大学》2005年硕士论文

【摘要】：近年来,随着神经内镜的发展,其在神经外科的应用越来越广,但由于神经内镜自身的局限性,目前多被用于脑室系统的诊断和治疗中,为了更好地将神经内镜应用于脑室疾病的治疗中,我们开展了神经内镜经额手术入路的侧脑室和三脑室解剖结构的研究。目的:(1)为梗阻性脑积水患者行神经内镜下三脑室造瘘术提供可靠的应用解剖学资料。(2)探讨梗阻性脑积水患者脑室内解剖结构的病理变化特点。(3)为临床开展神经内镜经额入路手术提供应用解剖学资料。方法:18 例脑积水患者,其中 13 例梗阻性脑积水和 5 例交通性脑积水手术患者,观察神经内镜下三脑室和侧脑室的解剖特点和重要的解剖标志。结果:(1)神经内镜下脑室内重要的解剖路标有:脉络丛、室间孔、丘纹静脉、隔静脉、乳头体、导水管开口等。(2)神经内镜下脑积水可见脑室系统均有不同程度的扩大,室间孔均明显扩大,部分病例除脑室均匀扩大外,脑室结构常有一些解剖变异和病理改变。(3)经额入路神经内镜观察范围大,能清楚地观察到侧脑室的额角、体部、枕角的广泛区域,侧脑室内的重要解剖标志和神经血管结构观察清楚,进入三脑室后,可以观察到前达漏斗隐窝后至后连合的广泛区域。结论:(1)神经内镜下脑室内观察到的重要解剖路标是室间孔处的 Y形结构。(2)长期的脑积水和持续的脑室内压力增高能导致脑室内的解剖异常改变,它们对完成神经内镜下三脑室底造瘘术可能是重要的,要求在三脑室底造瘘术中给予特别的关注。(3)经额手术入路神经内镜观察范围大,是脑室内神经内镜手术最常见的手术入路,神经内镜经此入路可以完成多种手术。
[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.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2005
【分类号】：R651;R322

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