囊肿-腹腔分流术治疗儿童颅内大型蛛网膜囊肿的长期疗效分析  

Analysis on the long-term therapeutic effect of cyst-peritoneal shunting for large-sized intracranial arachnoid cyst in pediatric patients

作　　者：叶玉勤[1,2] 贾颜锋[1] 李泽[1] 刘卫平[1] 蒋晓帆[1] 李兵[1] 费舟[1] 贺晓生[1] 

机构地区：[1]第四军医大学西京医院神经外科,陕西西安710032 [2]解放军第163医院神经外科,湖南长沙410003

出　　处：《中华神经外科疾病研究杂志》2017年第5期402-406,共5页Chinese Journal of Neurosurgical Disease Research

基　　金：国家自然科学基金资助项目(81471264)

摘　　要：目的探讨囊肿-腹腔分流术治疗儿童颅内大型蛛网膜囊肿的长期疗效。方法对第四军医大学西京医院神经外科2010年1月至2014年5月囊肿-腹腔分流术治疗的142例颅内大型蛛网膜囊肿患儿资料进行回顾性分析,通过对临床症状、囊肿体积和并发症情况的3个月至6年的随访,分析影响术后疗效的因素,评估该术式的长期疗效。结果随访期内,术后囊肿体积较术前明显减小,而且随着术后时间的延长,囊肿逐渐缩小(P<0.05)。术后临床症状总缓解率为93.4%,囊肿总缩小率为98.5%。不同年龄段组、不同部位组之间的囊肿缩小率均有统计学差异(P<0.05)。男性组与女性组、左侧组与右侧组、不同直径组之间的囊肿缩小率差异无统计学意义(P>0.05)。术后出现并发症发生率为1.4%,经对症处理后均痊愈出院。结论对于儿童颅内大型蛛网膜囊肿,囊肿-腹腔分流术的临床疗效肯定,并发症率低,术后效果与患儿年龄和囊肿部位显著相关。Objective The long-term therapeutic effect of cyst-peritoneal shunting on pediatric patients with large-sized intracranial araehnoid cyst was investigated. Methods One hundred and forty-two hospitalized pediatric patients with large intracranial arachnoid cyst who accepted cyst-peritoneal shunting were included in the study. The post-operational changes of neurological symptoms, cyst volume and complications were followed up from 3 months to 6 years after surgery. Additionally, one-way analysis of variance between several factors and the prognosis was performed to investigate long-term outcome of shunting surgery. Results In the follow-up period, post-operative cyst volume was much smaller than that of pre- operation （ P 〈 0.05 ）. In particular, the cyst was gradually decreased as time went on （ P 〈 0.05 ）. The total remission rate of neurological symptoms was 93.4% and the cyst shrinkage rate was 98.5%. The statistical difference in shrinkage rate was found between supra-tentoria and infra-tentoria groups, and among groups of different ages （P 〈 0.05 ）. No obvious difference was found between male and female groups, left and right groups, and among several groups of different cyst diameters （P 〉 0.05 ）. However, two shunt- related complications （1. 4% ） were found after surgery and were cured in time. Conclusion Cyst- peritoneal shunting can be considered as a reasonable treatment for pediatric patients with large-sized intracranial arachnoid cyst, which has the advantages of favorable therapeutic effect and low rate of complications. The therapeutic outcome is associated with patient＇s age and araehnoid cyst location.

关 键 词：囊肿-腹腔分流术 蛛网膜囊肿 儿童 

分 类 号：R743.9[医药卫生—神经病学与精神病学]