经鼻蝶入路显微手术治疗垂体Rathke囊肿  

Microsurgery through endonasal transsphenoidal approach for Rathke cleft cysts (report of 13 cases)

作　　者：王俊文[1] 吴志敏[1] 熊左隽[1] 梁健[1] 何苗[1] 李俊[1] 

机构地区：[1]武汉市中心医院神经外科,430014

出　　处：《中国临床神经外科杂志》2013年第3期138-139,142,共3页Chinese Journal of Clinical Neurosurgery

基　　金：湖北省自然科学基金资助项目(NO:2009CDB118)

摘　　要：目的 探讨垂体Rathke囊肿的诊断及显微手术治疗。方法 回顾性分析2008年6月至2012年3月采用经鼻蝶入路手术治疗并通过病检确诊为垂体Rathke囊肿的13例患者的临床资料,对手术适应症、术前诊断、手术技巧和术后治疗等进行总结分析。结果 囊肿完全切除11例,大部分切除2例;全切率84.6%(11/13)。术后患者头痛及视觉障碍全部得到改善;7例术前有内分泌症状者中,6例恢复正常;本组无严重并发症及死亡病例。术后随访6月至5年,无复发病例。结论 垂体Rathke囊肿在临床上易与垂体腺瘤、囊性颅咽管瘤等混淆,经鼻蝶入路显微手术是治疗本病的有效方法。Objective To explore the diagnosis and microsurgical treatment of Rathke cleft cysts. Methods The clinical data of 13 patients with Rathke cleft cysts, who underwent microsurgery through endonasal transsphenoidal approach from June, 2008 to March, 2012, were analyzed retrospectively, including surgical indications, preoperative diagnosis, surgical technique, postoperative treatments and so on. Results Of 13 patients with Rathke cleft cysts, 11 （84.6%, 11/13） received the total resection of Rathke cleft cysts and 2 subtotal. The diagnosis of Rathke cleft cysts was definitely made before the surgery in 3 patients. The symptoms including headache and visual disturbance disappeared after the surgery in all the patients. The endocrine was restored to normal after the surgery in 6 of 7 patients with preoperative endocrine dysfunction. There was no serious complication and no patients died in all the patients. The following up from 6 months to 5 years showed that the cysts did not recurred during the following up in all the patients. Conclusions It sometimes is difficult to make definite diagnosis of Rathke cleft cyst before the surgery. Rathke cleft cyst may wrong diagnosed as pituitary adenoma or cystic craniopharyngioma. The microsurgery through endonasal transsphenoidal approach is an effective method to treat Rathke cleft cysts.

关 键 词：垂体RATHKE囊肿 经鼻蝶入路 显微手术 

分 类 号：R736.4[医药卫生—肿瘤] R651.13[医药卫生—临床医学]