先天性儿童外侧裂囊肿手术治疗疗效分析  

Surgical Management of Sylvian Arachnoid Cysts in Children

作　　者：陈若平[1] 刘剑钢[1] 方立浩[1] 魏嘉[1] 沈玉成[1] 

机构地区：[1]上海交通大学附属儿童医院神经外科,上海200040

出　　处：《中国医药导刊》2012年第4期559-561,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:回顾性分析20年来采用2种手术方法治疗儿童先天性外侧裂蛛网膜囊肿的疗效。方法:20年来手术治疗儿童先天性外侧裂蛛网膜囊肿29例,其中15例施行囊肿-腹腔分流术;2例施行囊肿切除+囊肿-腹腔分流术;2例施行单纯囊肿切除,10例在囊肿全切除术基础上,再施行基底池造瘘术。结果:施行囊肿-腹腔分流术和囊肿切除+囊肿腹腔分流的17例手术效果良好,囊肿基本消失。其中5例囊肿基本消失后拔出分流系统。2例单纯囊肿切除中,1例囊肿消失,1例术后6个月复发,再次行囊肿-腹腔分流术。余10例囊肿切除+基底池造瘘术的手术效果良好,无1例复发。结论:针对外侧裂蛛网膜囊肿的2种手术方法均疗效良好,囊肿-腹腔分流术的疗效肯定、手术操作简单、创伤小,长期随访结果表明,部分病例可以去除分流系统。而囊肿切除+基底池造瘘术不需要分流系统,可以避免因分流系统而导致的不良合并症。Objective： Analyzing retrospectively the effectiveness of surgical managements of sylvian arachnoid cysts in children during last twenty years.Methods： There were 29 cases of sylvian arachnoid cysts in this report,15 cases fulfilled cysto-peritoneal shunt,2 cases in marsupialization with cysto-peritoneal shunt meantime,2 cases in marsupialization,and 10 cases in cystocisternostomy based on marsupialization.Results： In cases of shunt,pure shunt and shunt with marsupialization,the cysts were disappeared almost,while shunts in 5 cases were removed in a couple of years post-operatively.In pure marsupialization,one cyst was disappeared,but another one was recured six months post-operatively.Then a shunt was fulfilled.In cystocisternostomy cases based on marsupialization,every cyst was also disappeared without recrudescence.Conclusion： In surgical managements of sylvian arachnoid cysts,the effectiveness was not only the advantage of shunt but also the evident simpleness of surgical skills and minimal invasion.The shunt was able to be removed in some cases a couple on years post-operatively.The avoidance of shunt was the key superiority of cystocisternostomy.So the complications of shunt were not observed in the cases of cystocisternostomy.

关 键 词：外侧裂蛛网膜囊肿 囊肿-腹腔分流术 囊肿切除术 基底池造瘘术 

分 类 号：R726.5[医药卫生—儿科]