神经束膜囊肿的显微外科治疗  

Microsurgical treatment of sacral perineural cysts

作　　者：李念金 

机构地区：[1]山东省郓城县人民医院神经外科,274700

出　　处：《中华神经医学杂志》2005年第3期279-280,共2页Chinese Journal of Neuromedicine

摘　　要：目的研究神经束膜囊肿的临床表现及影像学特点,确定适宜的治疗方法.方法对6例神经束膜囊肿患者的临床特点、治疗方法进行回顾性分析.结果6例患者,其中3例术后骶神经疼痛症状消失,2例明显减轻,1例以麻木表现者无明显变化,憋气及改变体位时无明显疼痛.3例2～3个月恢复.随访2个月～5年,未见囊肿复发.结论神经束膜囊肿临床少见,MRI仍是最灵敏、最有效的诊断方法.对于有典型骶神经根症状的患者,采用显微外科技术,行囊肿切除或部分切除、囊肿内减压术,可显著改善临床症状.Objective To evaluate clinical manifestations and imageological features of sacral perineural cyst and find appropriate therapies. Methods 6 patients with sacral perineural cyst admitted from May 1999 to April 2004 were analyzed retrospectively. All patients presented with radicular pain that was refractory to medication. Sacral laminectomies with microsurgical cyst resection or fenestration were performed for all 6 patients. Results Radicular pain was alleviated markedly in 3 cases and moderately in 2 cases but no improvement happened in 1 case with local numbness after surgery. 4 of 6 cases had local sensory deficits after surgery, but 3 of them recovered within 2~3 months. Follow-up was performed for all cases from 2 months to 5 years, with no complications. Conclusion MRI findings are useful in the diagnosis of sacral perineural cyst. Persistent pain, onset of sensory deficits, impotence, or incontinence, indicates the need of surgery. Microsurgical cyst resection or fenestration is effective in relieving refractory radicular pain and urinary incontinence associated with sacral perineural cyst.

关 键 词：神经束膜囊肿 显微外科治疗 显微外科技术 治疗方法 影像学特点 回顾性分析 临床表现 临床特点 疼痛症状 改变体位 囊肿复发 骶神经根 诊断方法 部分切除 囊肿切除 内减压术 临床症状 患者 MRI 

分 类 号：R651[医药卫生—外科学]