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目的探讨小儿分流调整失败后应用神经内镜技术治疗的方法和体会。方法应用单纯内镜手术方法,对6例脑室-腹腔分流调整失败患儿进行分流管调整术,脉络丛烧灼术,第三脑室造瘘术。结果5例先天性梗阻性脑积水、1例松果体区占位行脑室腹腔分流术后发生堵塞患儿,应用神经内镜技术进行治疗,手术过程顺利;3例患者有不同程度发热,持续时间2～7d;随访6个月至24个月病情明显好转,脑积水改善,分流管通畅。结论神经内镜对脑室-腹腔分流调整失败患儿进行治疗,具有微创、安全、准确、并发症少、经济等优点,是神经外科较好的治疗方法。
Objective To investigate the methods and experiences of neuroendoscopy after failure of pediatric shunt adjustment. Methods A total of 6 children with unsuccessful adjustment of ventriculoperitoneal shunt were treated with shunt adjustment, choroid plexus cautery and third ventrostomy with endoscopic surgery alone. Results 5 cases of congenital obstructive hydrocephalus, 1 case of pineal region occupy the peritoneal ventriculoperitoneal shunt occurred in children, the application of endoscopic neurosurgical treatment, the operation was smooth; 3 patients with varying degrees of fever, Duration 2 ~ 7d; 6 months to 24 months follow-up was significantly improved, hydrocephalus improved, shunt patency. Conclusion Neuroendoscopy is a good treatment for children with failure to adjust the ventricular-peritoneal shunt with minimal invasion, safety, accuracy, less complications and economy.