颅内常见部位蛛网膜囊肿的神经内镜治疗研究  

Study on endoscopic surgery for intracranial arachnoid cyst in common locations

作　　者：宋昭[1] 徐永革[2] 王洪正[3] 夏小雨[2] 李荣刚[4] 

机构地区：[1]南方医科大学深圳医院,518000 [2]北京军区总医院附属八一脑科医院神经外科 [3]深圳市罗湖区人民医院神经外科 [4]复旦大学附属金山医院

出　　处：《临床神经外科杂志》2016年第3期209-212,216,共5页Journal of Clinical Neurosurgery

摘　　要：目的探讨颅内好发部位蛛网膜囊肿(IAC)的内镜手术治疗经验。方法对21例颅内蛛网膜囊肿患者的临床资料进行回顾性分析。其中12例中颅窝AC及3例鞍上池IAC患者选择内镜部分IAC切除+IAC-基底池穿通术,6例后颅窝AC患者中5例行内镜部分IAC切除+脑池穿通术,1例患者行内镜IAC大部分切除术。对患者术后症状、体征以及并发症进行分析。结果 21例患者(1例失随访)中症状消失9例,改善9例,无明显变化2例。影像学复查显示,IAC张力消失3例,与术前相比,囊腔缩小、脑组织膨胀饱满14例,无明显变化3例。结论 IAC部分切除+囊肿-脑池穿通术的治疗效果较好,应作为影像学检查示与脑池、脑室比邻的AC患者的首选手术方式。Objective To investigate the experience of endoscopic surgery for intracranial subarachnoid cyst（IAC） in common locations. Method The clinical data of 21 patients with ICA were analyzed retrospectively. Of 21 patients, 12 were in middle cranial fossa and 3 in suprasellar cistern choose endoscopic partial cyst transection ＋ cyst-basal cistern fenestration, in 6 cases of posterior fossa,5 underwent partial AC transection ＋ cistern fenestration surgery with endoscopy, 1 underwent cyst subtotal resection with endoscopy. All patients＇ postoperative symptoms, signs, and postoperative complications were analyzed. Results Of 21 patients, 9 patients＇ symptoms disappeared , 9 patients＇ symptoms improved,2 had no obvious change and 1 case lost contact. The effective rate was 90.4%. Imaging review showed that AC tension disappeared in 3. Compared with the preoperative, 14 cases AC narrowed, brain tissue expanded and 3 had no obvious change. Conclusion Endoscopic method of partial AC transection ＋ AC-cistern fenestration should be the first choice of those AC adjacence to cistern and ventricle on imaging.

关 键 词：蛛网膜囊肿 神经内镜 神经外科手术 

分 类 号：R739.41[医药卫生—肿瘤]