神经内镜下不同入路切除Rathke囊肿的手术疗效比较  

Comparison of surgical curative effects of ablation of Rathke cyst through different approaches under neuroendoscopy

作　　者：洪良春[1] 吉健勇[1] 

机构地区：[1]解放军187医院神经外科,海口571159

出　　处：《西南国防医药》2016年第6期636-638,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的比较神经内镜下不同手术入路治疗Rathke囊肿的临床效果。方法选取我院收治的38例Rathke囊肿患者作为研究对象,随机分为A、B两组,各19例。A组采用神经内镜下经眉弓锁孔入路手术切除治疗,B组则采用神经内镜下经鼻蝶入路手术切除方案,比较两组治疗效果和术后并发症发生情况。两组均随访1年,统计复发率,采用生活质量评价量表评估患者末次随访生活质量改善情况。结果 A组手术时间(62.63±5.84)min显著短于B组(72.47±6.66)min(P<0.05),头痛、头晕、视力障碍、多尿多饮、耳鸣等症状改善时间均短于B组(P<0.05),术后并发症发生率(15.79%)低于B组(47.37%)(P<0.05);A组末次随访SF-36量表精神健康、社会功能维度评分高于B组(P<0.05);A组无一例复发,B组有2例复发。结论采用神经内镜下经眉弓锁孔入路治疗Rathke囊肿,术野清晰,损伤小,患者术后恢复速度快,并发症发生率低。Objective To compare the clinical effect of Rathke cyst treatment through differed approaches under neuroendoscopy.Methods A total of 38 patients who had been suffering Rathke cyst and had been admitted to our hospital were selected and randomly divided into groups A and B（n=19,respectively）.Group A received ablation treatment through the supraorbital keyhole approach under neuroendoscopy,while group B received ablation treatment through the nasal transsphenoidal approach under neuroendoscopy,and then the treatment effects and postoperative complications of the two groups were compared.The groups received one-year follow-up for statistics of recurrence rate,with the improvement of the quality of life of patients at the last follow-up assessed according to the QOP evaluation datasheet.Results The time in surgery of group A [（62.63±5.84） min] was significantly shorter than that of group B [（72.47 ±6.66） min]（P〈0.05）.The time for improving such symptoms as headache,dizziness,visual impairment,diuresis and polydipsia and tinnitus was shorter than of group B（P〈0.05）.The occurrence rate of postoperative complications（15.79%） was lower than that of group B（47.37%）（P〈0.05）.The composite scores for mental health and social function according to SF-36 datasheet of group A at the last follow-up were higher than that of group B（P〈0.05）.Group A showed no recurrence,while group B had two cases of recurrence.Conclusion Treatment of Rathke cyst through the supraorbital keyhole approach under neuroendoscopy ensures clear operative field,slight damage,rapid recovery and low incidence of complications.

关 键 词：RATHKE囊肿 神经内镜 手术入路 效果 

分 类 号：R651.11[医药卫生—外科学]