颅内蛛网膜囊肿手术治疗的临床分析

目的:探讨颅内蛛网膜囊肿的手术治疗方式及其疗效。方法:回顾性分析72例手术治疗的颅内蛛网膜囊肿患者的临床资料,神经内镜下囊壁部分切除+囊肿-脑室或脑池造瘘术16例,显微镜下囊肿切除术4例,显微镜下囊壁部分切除+囊肿-脑池造瘘术32例,囊肿-腹腔分流术20例。随访6个月～6 a(平均2.2a)。结果:67例患者经治疗后症状改善,有效率93.1%,随访CT或MRI显示83.3%(60/72)幕上蛛网膜囊肿体积显著减小,幕下蛛网膜囊肿体积无明显变化但症状显著改善。结论:有症状的蛛网膜囊肿患者均应积极治疗。针对不同患者选择合适的手术方式对预后有重要意义。神经内镜手术创伤小、并发症少,应继续推广应用。

Clinical analysis of surgical treatment of intracranial arachnoid cyst

Objective： To explore the surgical approaches of intracranial arachnoid cyst and the effects. Methods： The clinical data of 72 patients with intracranial arachnoid cyst treated with surgeries were retrospectively analyzed. 16 cases were treated by neuroendoscopic partial cystectomy and communication between cystic cavity and brain cistern,4 cases by microscopic cyst removal,32 cases by microscopic partial cystectomy and communication between cystic cavity,20 cases by cysts-peritoneal shunt. Follow-up was performed from 6 months to 6 years（ mean 2. 2 years）. Results： The symptoms of 93. 1%（ 67/72） of patients got improved,CT or MRI scans showed significant reduction of cyst size in 83. 3%（ 60/72） of supratentorial arachnoid cysts. No significant size changes were found in subtentorial cysts but symptomatic improvements were noted. Conclusion：Regardless of age and cyst location,patients with symptomatic arachnoid cysts should be treated actively. Proper surgery treatment was important for different patients. Neuroendoscopic operation is effective and secutity in the treatment of intraeranial arachnoid cyst,and should be used widely.