| 垂体Rathke's囊肿性质与患者临床表现和预后的相关性分析 |
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| 引用本文： | 淦,超,李朝曦,刘胜文,陈,娟,王宝峰,徐,钰,张华楸,雷,霆.垂体Rathke's囊肿性质与患者临床表现和预后的相关性分析[J].中国临床神经外科杂志,2015,0(10):580-583. |
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| 作者姓名： | 淦 超 李朝曦 刘胜文 陈 娟 王宝峰 徐 钰 张华楸 雷 霆 |
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| 作者单位： | 430030 武汉，华中科技大学同济医学院附属同济医院神经外科
通讯作者:雷 霆，E-mail:tlei@tjh.tjmu.edu.cn |
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| 摘 要： | 目的 探讨垂体Rathke's囊肿物理性状与患者症状和预后的关系。方法 回顾性分析2005年4月至2013年5月手术治疗的104例垂体Rathke's囊肿患者的临床资料，其中87例病人术后随访5~92个月，平均26.6个月。结果 本组囊肿直径为8~30 mm，平均（15.3±5.0）mm，其中<10 mm 7例，10~20 mm 69例，≥20 mm 28例。囊液含结晶54例，无结晶50例；囊液清亮37例，囊液粘稠67例。术后3个月复查MRI示囊肿全切除85例，囊肿残留2例；全切率为97.7%。术后复发3例，复发率为3.4%。头晕患者囊液含结晶的比例明显高于无头晕的患者（P<0.05）；垂体激素水平异常的患者囊液含结晶的比例明显高于垂激素正常的患者（P<0.05）；视力减退患者囊肿直径明显大于无视力减退者（P<0.01）。结论 垂体Rathke's囊肿囊内少量结晶与头晕有关，而大量结晶与垂体激素水平异常有关。手术治疗Rathke's囊肿的效果良好，术后并发症少，复发率低；术中处理好囊肿的分隔及囊内结晶是避免Rathke's囊肿残留与复发的关键。
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| 关 键 词： | Rathke's囊肿 囊肿性质 显微手术 临床表现 预后 相关性 |
Analysis of relationship of pituitary Rathke's cleft cyst texture with clinical symptoms and prognosis |
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| GAN Chao,LI Chao-xi,LIU Sheng-wen,CHEN Juan,WANG Bao-feng,XU Yu,ZHANG Hua-qiu,LEI Ting..Analysis of relationship of pituitary Rathke's cleft cyst texture with clinical symptoms and prognosis[J].Chinese Journal of Clinical Neurosurgery,2015,0(10):580-583. |
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| Authors: | GAN Chao LI Chao-xi LIU Sheng-wen CHEN Juan WANG Bao-feng XU Yu ZHANG Hua-qiu LEI Ting |
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| Affiliation: | Department of Neurosurgery, Tongji Hospital, Tongji Medical School, Huazhong University of Sciences and Technology, Wuhan 400030, China |
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| Abstract: | Objective To explore the relationship of pituitary Rathke's cleft cysts textures with the clinical symptoms and prognoses in patients with symptomatic pituitary Rathke's cleft cysts undergoing surgery. Method The clinical data of 104 patients with pituitary Rathke's cleft cysts, who underwent surgery from April, 2005 to May, 2013, were analyzed retrospectively. Eighty-seven patients were followed up from 5 to 92 months (mean, 26.6 months). Results The diameters ranged from 8 to 30 mm mean, (15.3±5.0) mm]. MRI 3 months after the surgery showed that of 87 patients 85 (97.7%) received the total resection of the cysts and 2 had residual cysts. The cleft cysts recurred in 3 (3.4%) patients. The occurrent rate of dizziness (41.0%, 16/39) was significantly higher in the patients with few intracystic crystals than that (16.0%, 8/50) in the patients without intracystic crystals (P<0.05). The occurrent rate of abnormal pituitary hormone level (73.3%, 11/15) was significantly higher in the patients with many intracystic crystals than that (40%, 20/50) in the patients without intracystic crystals (P<0.05). The cystic diameter (17.9±5.1) mm]was bigger in the patients with visual disturbance caused by the cleft cysts than that (14.1±4.5) mm] in the patients without visual disturbance (P<0.05). Conclusions The clinical symptoms are related to the cysts textures in the patients with pituitary Rathke's cleft cysts. The few intracystic crystals predispose the patients to dizziness and a large number of the intracystic crystals predispose the patients to abnormal hormone level in the patients with pituitary Rathke cleft cysts. The curative effect of surgery on the pituitary Rathke's deft cyst is good. The complications are fewer and the recurrent rate is lower after the surgery in the patients with pituitary Rathke's cleft cysts. The removal of cystic separation and intracystic crystals by the surgery are the keys to prevention of the cystic relapse. |
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| Keywords: | Pituitary Rathke's cleft cyst Texture Clinical symptom Prognosis Relationship |
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