内镜下与显微镜下经蝶手术治疗症状性Rathke囊肿的对比分析  

Surgery through transsphenoidal approach for symptomatic rathke cleft cysts: endoscopic surgery vs microsurgery

作　　者：黄斌[1] 李全才[1] 张庭荣[1] 郭运发[1] 吴昊[1] 罗坤[1] 

机构地区：[1]新疆医科大学第一附属医院神经外科,乌鲁木齐830054

出　　处：《中国临床神经外科杂志》2016年第5期264-266,共3页Chinese Journal of Clinical Neurosurgery

基　　金：新疆维吾尔自治区高技术研究发展项目(201417103)

摘　　要：目的探讨内镜下与显微镜下经蝶手术治疗症状性Rathke囊肿的有效性和安全性。方法2001～2015年收治症状性Rathke囊肿34例，显微镜下经鼻蝶手术12例（显微镜组），内镜下经鼻蝶手术22例（内镜组）。结果两组术后头痛有效率均为100％；显微镜组术后视力改善率为88．9％（8／9），内镜组为83．3％（5／6），两组无明显差异（P〉0．05）；显微镜组术后并发症发生率（16．7％）和复发率（8．3％）与内镜组（分别为13．5％和4．5％）均无明显差异（P〉0．05）。结论症状性Rathke囊肿的经蝶手术可以借助内镜切除肿瘤也可以借助显微镜下切除，两种手术方法疗效没有明显差异。Objective To compare effect of endoscope-assisted transsphenoidal surgery on symptomatic Rathke cleft cysts and its safety with those of microsurgery. Methods The clinical data of 34 patients with symptomatic Rathke cleft cysts, of whom, 22 underwent endoscope-assisted transsphenoidal surgery and 12 transsphenoidal microsurgery from 2001 to 2015, were analyzed retrospectively. All the patients were followed up for 5 years. Results There were insignificant differences in the curative effects and postoperative complication occurrence rate between both the groups （P〉0.05）. But the average hospital stay [（10.67±2.27） days] after the operation in the mierosurgery group was significantly more than that [（7.77±1.82） days] in the endoscopic group （P〈0.01）. Conclusions The curative effects of endoscope-assisted transsphenoidal surgery and transsphenoidal mierosurgery on symptomatic Rathke cleft cysts and their safety are good, but the hospital stay after the operation may be reduced in the patients with symptomatic Rathke cleft cysts undergoing endoscope-assisted transsphenoidal surgery compared to that in the patients undergoing transsphenoidal microsurgery.

关 键 词：RATHKE囊肿 内镜 显微镜 经蝶入路 手术 

分 类 号：R739.41[医药卫生—肿瘤] R651.11[医药卫生—临床医学]