儿童Rathke囊肿18例临床分析

目的分析、探讨儿童Rathke囊肿的临床特点及手术治疗。方法回顾性分析北京天坛医院1993年6月至2003年12月间,经手术及病理证实的18例儿童Rathke囊肿病例。结果患儿的主要临床表现为内分泌异常、视觉障碍、头痛。所有患儿均接受了显微外科手术治疗,其中经蝶手术2例,经额开颅16例;全切6例,近全切5例,大部切除7例。术后随访5个月至8年,绝大部分患者症状消失或改善,且均无复发。结论儿童Rathke囊肿术前确诊困难,影像学检查无特异性表现。对于儿童症状性Rathke囊肿,手术治疗可明确诊断、解除症状,患儿预后均良好。显微外科手术是治疗本病的有效方法。

Clinical Analysis of 18 Cases of Rathke's Cleft Cysts in Children

Objective To investigate the clinical manifestations of and treatment for surgery of Rathke cleft cysts in children.Methods The retrospective research is based on the analyses of 18 cases of Rathke cleft cysts in children between 1993 to 2003 in Tiantan hospital treated by microsurgery and diagnosed through pathological results.Results The main clinical manifestations included pituitary dysfunction,visual disturbance and headache.All the patients under went operations.Among them,16 cases were treated through frontal craniotomy.and 2 cases were treated by transsphenoidal microsurgery.Total resection occurred in 6 cases,subtotal resection in 12 cases.In the follow-up period from 5 months to 8 years,most of the symptoms in the patients were resolved or alleviated.No patient recurred.Conclusion It is difficult to establish the correct diagnosis of Rathke cleft cysts before operation in children.Imageological examinations were multiple and nonspecific. Microsurgery can prove the diagnosis,resolve the symptoms,and it is the effective way to treat the symptomatic Rathke's cleft cysts in children.