椎管内囊肿的诊断与治疗分析  

The Diagnosis and Treatment of the Intraspinal Cyst

作　　者：李建荣[1] 陈铮立[1] 魏雨雨[1] 叶世泰[1] 

机构地区：[1]中国人民解放军第117医院神经外科,浙江杭州310004

出　　处：《河北医学》2013年第12期1823-1824,共2页Hebei Medicine

摘　　要：目的:探讨椎管内囊肿的诊断和治疗方法,提高诊治水平。方法:对22例患者的临床表现、影像学检查和治疗情况以及5年的随访情况进行分析。结果:22例患者,病程最长8年,最短20天,下肢肌力减退12例,腰、骶尾部疼痛不适8例,肛门坠落感、小便潴留2例,下肢及臀部肌肉萎缩4例。MRI检查显示椎管内囊肿。手术治疗18例,4例因病程较短门诊观察治疗。随访17例症状和体征全部消失,3例缓解,2例术后缓解,3个月后症状复发,予门诊保守治疗。结论:椎管内囊肿病程缓慢,临床表现及体征不典型,耐心、细致的体格检查必不可少,MRI是首选的影像学检查手段,对有明显的神经定位体征,且与影像学相吻合的患者,手术治疗效果理想。Objective： To discuss the diagnosis and treatment of the intraspinal cyst. Method： The clinical manifestation, examination results and therapeutical effects as well as 5-year following up of 22 pa- tients were analyzed. Result： The clinical history of 22 patients lasted from 20 days to the longest duration of 8 years. 12 patients presented weakness of leg , 8 cases suffered pain or uncomfortableness in the lumbosa- oral region, 4 cases had muscle atrophy in the leg or hip and 2 cases had urinary dysfunction. All were illus- trated neurocanal cyst by MRI examination. 18 cases underwent surgery and 4 cases be observed in outpa- tient department because of short history. Through 5- year following up, 17 cases were asymptoms and 3 pa- tients symptoms -remission. 2 cases felt release after surgery but complained recurrence 3 months following up. Conclusion： The clinical history of the intraspinal cyst are long and slow, and the symptoms be compli- cated and untypical. MRI examination can make a definite diagnosis. But careful physical examination is necessary. Successful surgical treatment of symptomatic cysts is dependent on appropriate patient selection.

关 键 词：椎管内囊肿 诊断 治疗 

分 类 号：R651[医药卫生—外科学]