探讨症状性骶管囊肿囊液性状与介入治疗预后的关系

目的 探讨症状性骶管囊肿患者囊液性状与介入治疗预后的关系.方法 114例症状性骶管囊肿患者,均有腰骶部不适等症状,其中初发86例,复发28例.在DSA引导下经皮穿刺进入囊肿内,抽吸2～5 ml脑脊液送实验室检查.然后再注入少量非离子型对比剂使囊肿显影,判断囊肿与蛛网膜下腔是否相通,最后再采用双针法抽吸囊液.结果 造影显示114例患者中66例患者显示囊肿与蛛网膜下腔相通,48例患者显示囊肿与蛛网膜下腔不相通;初发患者中两组脑脊液糖、氯化物差异有统计学意义,复发患者中两组脑脊液糖、蛋白质、氯化物差异有统计学意义.脑脊液的单项、多项改变与患者的介入治疗预后差异有统计学意义.结论 骶管囊肿分为与蛛网膜下腔通和不通的两种类型.初发和复发患者相比,脑脊液性状发生变化.脑脊液多项改变以及脑脊液糖升高、氯化物降低与患者介入治疗预后相关.

The relationship between the cystic fluid characteristics of symptomatic sacral canal cyst and the interventional therapeutic prognosis

Objective To investigate the relationship between the cystic fluid characteristics of symptomatic sacral canal cyst and the interventional therapeutic prognosis.Methods A total of 114 patients with symptomatic sacral canal cyst were enrolled in this study.Clinically,all patients complained of discomfort at lumbosacral area.Among the 114 patients,86 were primary sacral canal cyst and 28 were recurrent sacral canal cyst.Under DSA guidance,percutaneous puncturing of the cyst was performed,2-5 ml cerebrospinal fluid (CSF) was aspirated and sent for laboratory tests.Then a small amount of nonionic contrast agent was injected into the cyst to determine whether the cyst was communicated with the subarachnoid space or not.Finally,double-needle method was used to aspirate the cyst fluid.Results Radiography showed that communication between the cyst and subarachnoid space was detected in 66 patients (group A),while no communication between the cyst and subarachnoid space was observed in 48 patients (group B).In patients with primary symptomatic sacral canal cyst,the differences in the sugar and chloride levels of CSF between group A and group B were statistically significant.In patients with recurrent symptomatic sacral canal cyst,the differences in the sugar,protein and chloride levels of CSF between group A and group B were also statistically significant.Statistically significant correlation existed between the single or multiple CSF changes and the interventional therapeutic prognosis.Conclusion Sacral canal cysts can be classified into two types:cyst-subarachnoid space communicating type and cyst-subarachnoid space non-communicating type.The characteristics of CSF in patients with primary symptomatic sacral canal cyst are different from those in patients with recurrent symptomatic sacral canal cyst.Multiple CSF changes,the increased sugar level and decreased chloride level in CSF are well correlated with the interventional therapeutic prognosis.