症状性颅内蛛网膜囊肿的临床治疗分析  

Clinical treatment of symptomatic intracranial arachnoid cyst

作　　者：黄庆锋[1] 施炜[1] 苏星[1] 卢小健[1] 顾志恺[1] 陈建[1] 

机构地区：[1]南通大学附属医院神经外科,南通226001

出　　处：《中华神经医学杂志》2012年第8期796-798,共3页Chinese Journal of Neuromedicine

摘　　要：目的探讨症状性颅内蛛网膜囊肿（IAC）的手术治疗方法、适应证及其治疗效果。方法回顾性分析南通大学附属医院神经外科自2000年1月至2010年1月收治的32例IAC患者临床资料，总结其手术方法及疗效。结果本组2例保守治疗的患者失随访。随访结束时，23例（72％）患者症状明显改善（囊肿体积缩小或临床症状缓解），6例（18％）患者症状无改变（临床症状和囊肿大小无改变），1例（3．1％）巨大鞍区-鞍上区IAC患者症状加重（临床症状恶化或囊肿增大）；术后影像学检查显示囊肿消失4例（12．5％），囊肿缩小16例（50％），囊肿大小无改变12例（37．5％）。结论IAC的主要手术适应证是颅内高压、确切的神经系统损害、脑组织压迫。显微外科手术以及神经内镜是治疗IAC的有效方法。Objective To explore the clinical features and surgical indications of patients with symptomatic intracranial arachnoid cyst （IAC） and their surgical effect. Methods We retrospectively reviewed the clinical data of 32 patients with IAC, admitted to our hospital from January 2000 to January 2010. Post-therapeutic results were clinically and radiologically assessed. Results The follow-up ranged from 12 to 108 months; 2 patients received conventional treatment were lost of follow-up. Good outcome was noted in 23 patients （shrank cyst volume or alleviated clinical symptoms, 72%）; 6 patients （no changes in cyst volume or clinical symptoms, 18%） remained unchanged, while only 1 （3.1%） had worsened giant suprasellar cyst. Imageological diagnosis showed disappearance of cyst in 4 （12.5%）, decreased volume of cyst in 16 （50%） and no changes of cyst in 12 （37.5%）. Conclusion The major indications of surgery for IAC include intracranial hypertension, damage in nervous system and compression of the cerebral tissues. Surgery excision and marsupialization of symptomatic patients can provide good results.

关 键 词：蛛网膜囊肿 囊肿切除术 囊肿-腹腔分流术 神经内窥镜 立体定向技术 

分 类 号：R651.1[医药卫生—外科学]