探讨Ommaya储液囊植入术在围手术期处理后颅窝肿瘤并脑积水的意义。

回顾性分析自2005年1月至2015年1月汕头大学医学院第二附属医院神经外科收治的12例确诊为后颅窝肿瘤患者的临床资料。所有患者术前颅脑CT或MRI均提示伴发不同程度梗阻性脑积水。开颅术前手术植入Ommaya储液囊8例，开颅术中植入Ommaya储液囊4例。

12例患者均未发生肿瘤切除术前脑积水所致脑疝危象。其中有11例在肿瘤切除术后2周复查CT见小脑及脑干水肿消退、脑室大小正常，康复出院；1例因髓母细胞瘤侵犯脑干无法全切，术后需反复抽液缓解脑积水，故在术后3周时行姑息性脑室腹腔分流术，第5周时症状缓解后出院。12例患者均未发生术后伤口脑脊液漏或颅内感染。

Ommaya储液囊植入术是预防围手术期后颅窝肿瘤并梗阻性脑积水突发脑疝危象值得推荐的治疗手段。

To investigate the clinical effect of Ommaya reservior implanation in obstructive hydrocephalus complicated with posterior cranial fossa tumor in perioperative period.

Data of 12 confirmed cases with posterior cranial fossa tumor admitted to research center for translational medicine, the second affiliated hospital of shantou university medical college and department of neurosurgery, the first affiliated hospital of shantou university medical college were retrospectively reviewed. All the patients appeared obstructive hydrocephalus in different degrees through the CT or MRI scan. Ommaya reservoirs implanation was applied on 8 cases before and 4 cases during the posterior cranial fossa tumor resection.

There were no cerebral hernia caused by obstructive hydrocephalus before tumor resection in all cases. The cerebellum and brainstem edema recede and normal ventricle size were found through CT scan two weeks after tummor resection in 11 cases, who were successfully discharged. One patient underwent ventriculoperitoneal shunt (VPS) 3 weeks after operation since of the Medulloblastomas invaded the brainstem and couldn’t be totally removed. This patient discharged in the 5th week. All the 12 cases were no cerebrospinal fluid leakages or intracranial infections postoperative.

This study suggests that Ommaya Reservoir implanation is worth a recommendation for obstructive hydrocephalus complicated with posterior cranial fossa tumor in perioperative period.