發(fā)布時間：2018-06-16 13:20

  本文選題：腦積水 + 神經(jīng)內(nèi)鏡��； 參考：《山西醫(yī)科大學(xué)》2005年碩士論文

【摘要】：近年來,隨著神經(jīng)內(nèi)鏡的發(fā)展,其在神經(jīng)外科的應(yīng)用越來越廣,但由于神經(jīng)內(nèi)鏡自身的局限性,目前多被用于腦室系統(tǒng)的診斷和治療中,為了更好地將神經(jīng)內(nèi)鏡應(yīng)用于腦室疾病的治療中,我們開展了神經(jīng)內(nèi)鏡經(jīng)額手術(shù)入路的側(cè)腦室和三腦室解剖結(jié)構(gòu)的研究。 目的:(1)為梗阻性腦積水患者行神經(jīng)內(nèi)鏡下三腦室造瘺術(shù)提供可靠的應(yīng)用解剖學(xué)資料。(2)探討梗阻性腦積水患者腦室內(nèi)解剖結(jié)構(gòu)的病理變化特點(diǎn)。(3)為臨床開展神經(jīng)內(nèi)鏡經(jīng)額入路手術(shù)提供應(yīng)用解剖學(xué)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(shù)患者,觀察神經(jīng)內(nèi)鏡下三腦室和側(cè)腦室的解剖特點(diǎn)和重要的解剖標(biāo)志。 結(jié)果:(1)神經(jīng)內(nèi)鏡下腦室內(nèi)重要的解剖路標(biāo)有:脈絡(luò)叢、室間孔、丘紋靜脈、隔靜脈、乳頭體、導(dǎo)水管開口等。(2)神經(jīng)內(nèi)鏡下腦積水可見腦室系統(tǒng)均有不同程度的擴(kuò)大,室間孔均明顯擴(kuò)大,部分病例除腦室均勻擴(kuò)大外,腦室結(jié)構(gòu)常有一些解剖變異和病理改變。(3)經(jīng)額入路神經(jīng)內(nèi)鏡觀察范圍大,能清楚地觀察到側(cè)腦室的額角、體部、枕角的廣泛區(qū)域,側(cè)腦室內(nèi)的重要解剖標(biāo)志和神經(jīng)血管結(jié)構(gòu)觀察清楚,進(jìn)入三腦室后,可以觀察到前達(dá)漏斗隱窩后至后連合的廣泛區(qū)域。 結(jié)論:(1)神經(jīng)內(nèi)鏡下腦室內(nèi)觀察到的重要解剖路標(biāo)是室間孔處的 Y形結(jié)構(gòu)。(2)長期的腦積水和持續(xù)的腦室內(nèi)壓力增高能導(dǎo)致腦室內(nèi)的解剖異常改變,它們對完成神經(jīng)內(nèi)鏡下三腦室底造瘺術(shù)可能是重要的,要求在三腦室底造瘺術(shù)中給予特別的關(guān)注。(3)經(jīng)額手術(shù)入路神經(jīng)內(nèi)鏡觀察范圍大,是腦室內(nèi)神經(jīng)內(nèi)鏡手術(shù)最常見的手術(shù)入路,神經(jīng)內(nèi)鏡經(jīng)此入路可以完成多種手術(shù)。
[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(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2005
【分類號】：R651;R322

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本文編號：2026842