神经内镜下脑室囊肿脑池造瘘术治疗儿童鞍上蛛网膜囊肿  

Efficacy of neuroendoscopic ventriculocystocisternostomy for pediatric suprasellar arachnoid cysts

作　　者：李王安[1] 荆国杰[1] 姚晓腾[1] 林才[1] 李毅毅[1] 

机构地区：[1]惠州市第一人民医院神经外科,惠州市神经外科研究所,516003

出　　处：《中华小儿外科杂志》2016年第3期177-180,共4页Chinese Journal of Pediatric Surgery

摘　　要：目的探讨神经内镜下脑室囊肿脑池造瘘术治疗儿童鞍上蛛网膜囊肿疗效。方法回顾性分析采用神经内镜下脑室囊肿脑池造瘘手术治疗的6例儿童鞍上蛛网膜囊肿患儿临床和影像学资料，所有患儿术后均随访1年。结果6例患儿术中均成功造瘘，术前颅内压升高4例和行走不稳、小便失禁2例的症状在术后均得到明显改善。通过MRIT2轴位图像上双侧额角最大宽度对比，患儿术前双侧额角最大宽度为（73．0±5．5）min，术后1年为（70．0±7．4）mm，差异无统计学意义（P〉0．05），提示患儿脑积水程度改善不明显。通过MRIT2正中矢状位对比，患儿术前囊肿大小为（44．0±6．1）mm，术后1年为（25．0±3．3）mm，差异有统计学意义（P〈0．01），提示术后囊肿明显缩小。术后脑脊液电影提示导水管和造瘘口通畅，无手术死亡病例。结论神经内镜下脑室囊肿脑池造瘘术治疗儿童鞍上蛛网膜囊肿创伤小，疗效满意，可作为本病治疗首选的手术方法。Objective To explore the efficacy of endoscopic ventriculocystocisternostomy for suprasellae arachoid cysts. Methods Six children of suprasellae arachoid cysts underwent neuroendoscopic ventriculocystocisternostomy. And the follow-up period was over 1 year. Their clinical and imaging data were analyzed. Results Such symptoms of hydrocephalus as headache, walking instability and urinary incontinence were relieved. Postoperative magnetic resonance imaging （MRI） showed a decrease of cyst volume in all cases （44. 0 ± 6. 1 vs 25.0 ± 3.3 mm, P〉0. 01）. However, hydrocephalus was not relieved significantly （73.0 ±5.5 vs 70.0± 7. 4 ram, P〉0.05）. Cine-MR imaging confirmed a fluent flow of cerebrospinal fluid （CSF） through all fenestration sites and aqueduct. There was no operative mortality. Conclusions Endoscopic ventriculocystocisternostomy is both effective and safe for suprasellar aracbnoid cysts.

关 键 词：神经内窥镜 蛛网膜囊肿 脑室造口术 

分 类 号：R726.5[医药卫生—儿科]