鞍区Rathke囊肿的诊断及显微手术治疗

目的 探讨鞍区Rathke囊肿的术前诊断和手术治疗。方法 对2000年3月至2007年6月我院收治的21例经手术及术后病理检查证实的Rathke囊肿病人的临床资料进行回顾性分析。此21例中。8例男性，13例女性；入院后21例病人均行了头颅CT和MRI检查。鞍区Ratllke囊肿患者临床表现包括头痛、视野缺损及内分泌功能紊乱等。15例经鼻-蝶窦入路，6例经右侧额下入路显微手术切除病变。结果 术前正确诊断为Rathke囊肿11例。其余10例均被误诊。术后随访3个月至5年，患者头痛症状和视力、视野障碍均有改善，术前有内分泌功能障碍者术后63．6％（7／11）得到改善，无复发病例。结论 鞍区Rathke囊肿术前较难明确诊断。MRI检查有助于其鉴别诊断。经蝶窦显微手术是有效的治疗方法。

Diagnosis and Microsurgery of Rathke Cleft Cysts in the Sellar Regions

Objective To explore the diagnosis and microsurgery of Rathke cleft cysts in the sellar regions. Methods The clinical data of 21 patients with Rathke cleft cysts, of whom, 8 were male and 13 female, were analyzed retrospectively. The typical clinical manifestations included headache, visual deficiency and endocrine dysfunction in the patients with sellar region Rather cleft cysts. CT and MRI examinations were performed in all the patients before the microsurgery. Of 21 patients, 15 underwent transphenoidally microsurgery and 6 microsurgery through right subfrontal approach in our department from March, 2000 to June, 2007. Results Rather cleft cysts were proved by the operation and patholofical examination. Rathke cleft cysts were correctly diagnosed as by MRI before the surgery in only 11 patients. The following-up from 3 months to 5 years after the operation showed that all the patients were improved in symptoms including visual deficiency and the headache. The pituitary function was improved in 63.6%（7111） of the patients with preoperative endocrine dysfunction. Rathke cleft cysts did not recur in all the patients. Conclusions The correct diagnosis of Rathke cleft cysts is relatively difficult before the surgery, but MRI is helpful to its differential diagnosis. Transsphenoidal microsurgery is an effective method to treat Rathke cleft cysts.