儿童颅内蛛网膜囊肿的外科治疗探讨

目的 探讨儿童颅内蛛网膜囊肿外科治疗的手术方法、适应证及并发症.方法 回顾分析53例手术患儿的临床资料,囊肿切除并脑池交通术42例,囊肿-腹腔分流术10例,神经内镜下囊肿切除并造瘘术1例.结果 患者术后恢复均良好,临床症状均有不同程度改善.术后高热(>39.1℃)及持续发热(>3d)13例;形成皮下积液8例,再次硬膜修补术2例.术后随访3个月以上,CT证实囊肿缩小或消失50例,无明显变化3例.结论 上述三种术式均是治疗儿童颅内蛛网膜囊肿的有效方案,但应综合多种因素采取个体化的治疗,并重视预防其相关术后并发症.

Surgical treatment of intracranial arachnoid cysts in children

Objective To explore the techniques, indications and complications of the surgery for intracranial arachnoid cysts (IACs) in children. Methods The clinical data of 53 children with intracranial arachnoidal cysts were anlyzed retrospectivley. The craniotomy was performed for resecting part of the walls of IACs and opening subarachnoid cavity and relative cistern in 42 patients; the cystoperitoneal shunt was performed in 10 patients, and the endoscopic fenestrations of IACs in 1 case. Results All the patients have good recovery after the operation, the clinical symptoms got improved in different degrees. 13 cases showed hyperpyrexia (>39.1℃) after operation and consistant fever (duration was longer than 3 days); Subcutanous hydrops happened in 8 cases. 2 cases took duraneoplast again. CT scans which were took more than 3 months after operation showed that IACs were completely obliterated or obviously decreased in 50 cases and unchanged in 3 cases. Conclusions All the above 3 operation types were effective methods to cure IACs of children, we should pay more attention to individualized healing and prevention of the complications after the operations.