外侧裂蛛网膜囊肿手术方式分析

目的 探讨外侧裂蛛网膜囊肿手术方式的选择.方法 南方医科大学南方医院神经外科自2003年3月至2008年8月共采用手术治疗外侧裂蛛网膜囊肿患者87例,按手术方式(单纯内镜下手术40例、内镜控制下手术19例、显微镜下囊肿切除术22例)的不同将患者分为单纯内镜组、内镜控制组和显微镜组(分流及混合手术患者6例未计入),回顾性分析患者的临床资料并比较上述3种手术方式的疗效和并发症的发生率.结果 3组患者的年龄、囊肿大小、术后并发症、病情好转和囊肿缩小情况差异无统计学意义(P>0.05),而显微镜组患者的手术时间[(143±36.0)min]、术中出血[(160±39.6)mL]均高于其它2组,差异有统计学意义(P<0.05),单纯内镜组[(97±26.8)min,(15±4.8)mL]和内镜控制组患者[(87±27.6)min,(18±5.7)mL]的手术时间和术中出血量差异无统计学意义(P>0.05).结论 内镜下手术治疗外侧裂蛛网膜囊肿所需时间短,术中出血少,优于显微镜开颅手术.

Surgical methods in patients with Sylvian fissure arachnoid cysts

Objective To choose the appropriate operation for patients with Sylvian fissure arachnoid cysts.Methods The data of 87 patients with intracranial arachnoid cysts(67 male,20 female,mean age 13.4 years),admitted to out hospital from March 2003 to August 2008,were retrospectively analyzed.Forty of them accepted simple endoscopic neurosurgery;19 of them accepted endoscope-controlled neurosurgery;22 of them accepted microsurgery.The efficacy and complications of these 3 methods were analyzed and compared.Results No significant differences on age,the size of the cysts,postoperative complications,the decreased size of the cysts and the improvement were found among these 3 methods(P>0.05).The operation time and bleeding volume of the simple endoscopic neurosurgery group were 97±26.8 min and 15±4.8 mL;the endoscope-controlled neurosurgery group were 87±27.6 min and 18±5.7 mL;the microsurgery group were 143±36.0 min and 160±39.6 mL.As compared with those in the first 2 groups,the operation time was statistically longer and the bleeding volume was obviously increased in the later group(P<0.05);while no significant difference of those was found between the first 2 groups(P>0.05).Conclusion Endoscopic neurosurgery is an effective method with shorter operation time and less bleeding than craniotomy in treating the Sylvian fissure arachnoid cysts.