经鼻蝶入路囊液引流术治疗Rathke囊肿的手术分析  

Cysts fluid drainage through endonasal transsphenoidal approach for Rathke's cleft cysts(report of 66 cases)

作　　者：王友伟[1] 马驰原[2] 王汉东[2] 杭春华[2] 成惠林[2] 樊友武[2] 孙康健[2] 李杰[2] 

机构地区：[1]南京大学临床学院神经外科,南京210002 [2]南京军区南京总医院神经外科,南京210002

出　　处：《中国临床神经外科杂志》2012年第12期735-737,共3页Chinese Journal of Clinical Neurosurgery

基　　金：国家自然科学基金资助项目(30801178)

摘　　要：目的探讨治疗Rathke囊肿最佳手术方式。方法对手术治疗的66例Rathke囊肿病人的临床资料进行回顾性分析。采用经鼻蝶入路囊液引流49例(A组);采用囊液引流+囊壁大部分切除17例(B组)。结果 A组随访40例(9例失访),平均随访40.9月,症状消失26例,部分缓解12例,复发2例;B组随访10例(7例失访),平均随访47.4月,症状消失6例,部分缓解3例,复发1例。A组术后脑脊液鼻漏3例,尿崩16例(其中永久性尿崩1例);B组术后脑脊液鼻漏4例,尿崩6例(其中永久性尿崩4例),脑出血1例,硬膜下血肿1例。结论经鼻蝶入路囊液引流术不但能有效缓解症状,而且其术后并发症少,复发率低,是目前治疗Rathke囊肿最安全有效的手术方式。Objective To explore the best procedures of surgery for Rathke＇ s cleft cysts （RCCs）. Methods The clinical data of 66 patients with RCCs, of whom, 49 underwent only the cyst fluid drainage through the endonasal transsphenoidal approach （group A） and 17 did the cyst fluid drainage and resection of the cyst walls （group B）. Results The clinical symptoms disappeared in 26, ones were relieved in 12 and the RCCs recurred in 2 of 40 patients followed up from 1 to 129 months （mean, 40.9 months） in group A. The clinical symptoms disappeared in 6, ones were relieved in 3 and the cyst recurred in 1 of 10 patients followed up from 1 to 129 months （mean, 47.4 months） in group B. The postoperative complications included cerebrospind fluid leak in 3 patients and diabetes insipidus in 16 in group A, and cerebrospinal fluid leak in 4 patients, diabetes insipidus in 6, cerebral hemorrhage in 1 and subdural hematoma in 1 in group B. Conclusion The cyst fluid drainage through the endonasal transsphenoidal approach is an effect method to treat RCCs.

关 键 词：RATHKE囊肿 手术方式 经鼻蝶入路 复发 

分 类 号：R739.41[医药卫生—肿瘤] R739.45[医药卫生—临床医学]