神经内镜治疗后颅窝蛛网膜囊肿的临床分析  

The Clinical Analysis of Endoscopic Management for Posteror Fossa Arachnoid Cyst

作　　者：周锦尧[1] 彭玉平[1] 郭邦明[1] 李宏[1] 

机构地区：[1]广州南方医科大学南方医院神经外科,广州510515

出　　处：《医学综述》2014年第1期178-180,共3页Medical Recapitulate

摘　　要：目的探讨临床神经内镜治疗颅内后颅窝蛛网膜囊肿的疗效。方法回顾性分析2006年2月至2012年8月在广州南方医科大学南方医院神经外科治疗的后颅窝蛛网膜囊肿患者46例。所有患者均经头颅CT和磁共振成像(MRI)检查,并根据不同手术方式进行分组,其中开颅囊肿切除术10例(A组),神经内镜囊肿造瘘术23例(B组),分流术6例(C组),未行手术7例。结果术后随访3个月至6年,复查头颅MRI结果显示26例患者后颅窝蛛网膜囊肿及扩大的脑室系统较术前缩小,无明显变化13例,有效率:A组60.0%、B组69.1%、C组66.7%(P>0.05)。术后症状消失18例、明显好转16例、无明显好转5例,有效率:A组80.0%、B组91.3%、C组83.3%(P>0.05);并发症发生率:A组40.0%、B组13.1%、C组33.3%(P>0.05)。结论不同手术治疗后颅窝蛛网膜囊肿的效果无明显差异,但是神经内镜作为微创手段,更安全、简便,并发症少,恢复快。Objective To explore the effect of endoscopic treatment of intracranial posterior cranial fossa arachnoid cyst. Methods Data of 46 patients with posterior cranial fassa araehnoid cyst treated in Depart- ment of Neurosurgery of Nanfang Hospital of Southern Medical University, were retrospectively reviewed. All patients were examined by CT and MRI, and were grouped according to different operative techniques, cyst resection by craniotomy in 10 cases（ group A） ,endoscopic cyst fenestration in 23 cases（ group B） ,cyst shun- ting in 6 eases （ group C）, without operation in 7cases. Results All cases were followed up from 3 months to 6 years, MRI showed ventrieular system extension and arachnoid cyst were reduced in 26 patients after opera- tion,no changes in 13 eases. Efficacy of group A was 60.0% ,group B was 69.1% ,group C was 66.7% （ P 〉 0.05）. Symptoms disappeared in 18 cases, significantly improved in 16 cases, no improvement in 5 cases. Effective rate was 80.0% in group A,91.3% in group B, 83.3% in group C （ P 〉 0.05 ）. Surgical complication rate was 40.0% in group A, 13.1% in group B ,33.3 % in group C （ P 〉 0.05 ）. Conclusion There were no significant differences of efficacy between different groups for posterior arachnoid cyst, but endoscopic means,as a minimally invasive approach, is more safe, convenient, with less complications and rapid recovery.

关 键 词：蛛网膜囊肿 后颅窝 神经内镜 

分 类 号：R651.11[医药卫生—外科学] R742.8[医药卫生—临床医学]