开颅手术与分流手术治疗颅内蛛网膜囊肿的临床效果比较

目的 比较开颅手术与分流手术治疗颅内蛛网膜囊肿的临床效果.方法 对吉林大学中日联谊医院2000年1月至2013年6月收治的72例行手术治疗的颅内蛛网膜囊肿患者的临床资料进行回顾性分析.根据手术方式将患者分为开颅组（脑蛛网膜囊肿切除术20例）和分流组（脑囊肿-腹腔分流术52例）.比较2组患者手术时间、术中出血量、住院时间、治疗费用、术后临床症状改善情况、术后并发症情况及术后囊肿复发情况.结果 与开颅组比较,分流组手术时间短[（2.20 ±0.05） min比（2.90±0.29） min]、术中出血量少[（104 ±4）ml比（158±14） ml],差异均有统计学意义（均P＜0.05）,而住院时间、术后临床症状改善情况、术后并发症发生情况及术后囊肿复发情况比较,差异均无统计学意义[（8.40±0.18）d比（8.50 ±0.27） d,88.5％ （46/52）比90.0％ （18/20）,15.4％ （8/52）比20.0％ （4/20）,11.5％ （6/52）比10.0％ （2/20）]（均P＞0.05）.结论 开颅手术与分流手术对于颅内蛛网膜的治疗各有其优缺点.颅内蛛网膜囊肿手术方式的选择应根据囊肿的部位、疾病的特殊性、术者手术操作的熟练程度等因素综合考虑.

Clinical analysis of craniotorny and shunt surgery in treatment of intracranial arachoid cyst

Objective To compare the clinical efficacy between craniotomy and shunt surgery in the surgical treatment of intracranial arachoid cyst（IAC）.Methods Totally 72 cases with IAC were collected from January 2000 to June 2013.The clinical data was analyzed retrospectively.According to the different methods of operation,patients were divided into craniotomy group （20 cases,resection of brain arachnoid cysts） and shunt group （52 cases,cyst peritoneal shunt）.Operation time,intraoperative blood loss,hospitalization expenses,hospital stay,postoperative clinical symptoms improvement,complications and cyst recurrence were compared between craniotomy group and shunt group.Results Compared with craniotomy group,shunt group had shorter operation time[（2.20 ± 0.05）min vs （2.90 ± 0.29）min],less intraoperative blood loss [（104 ± 4）ml vs （158 ± 14）ml] ;the difference was significant （P 〈 0.05）.No significant difference was noted in hospital stay,postoperative clinical symptoms improvement,complications and cyst recurrence [（8.40 ± 0.18）d vs （8.50 ± 0.27）d,88.5% （46/52） vs 90.0% （18/20）,15.4% （8/52） vs 20.0% （4/20）,11.5 % （6/52） vs 10.0% （2/20）] （all P 〉 0.05）.Conclusion The operation method should be selected comprehensively according to the location of cyst,the particularity of disease and the experience of the surgeon.