治疗颅内蛛网膜囊肿两种常见手术方式的分析

摘要

ObjectiveTo explore the indications and clinical effect of two surgical techniques: to partially removed adding communication with subarachnoid space(Technique A)and simple cyst-peritoneal shunt(Technique B)for intracranial arachnoid cysts(IAC).MethodsA retrospective analysis was made of 81 patients with IAC and complete clinical data from Jan 2008 to Jan 2013,among them, 52 cases was treated with technique A,22 cases was treated with technique B and 7cases was removed of the cysts totally. According to different surgical techniques,the statistical results show that 43 cases(82.7%)achieved obvious to complete remission, 5 cases(9.6%)got no obvious remission and 4 cases(7.7%)got recurrence, in all the patients who were performed by Technique A;meanwhile 18 cases(81.8%)achieved obvious even complete remission;3 cases(13.6%)got no obvious remission and 1 cases(4.5%) got recurrence in all the patients who were performed by Technique B.ConclusionBoth of the two surgical techniques have obvious curative effect on the treatment of IAC,but teenager patients and the one who shows shallow location of cyst are more suitable for Technique A,while senior patients and the one who shows deep location of cyst or large cyst are more suitable for Technique B.%目的：探讨囊肿大部切除+蛛网膜下腔疏通术（A术式）和单纯囊肿-腹腔分流术（B术式）两种手术方式治疗颅内蛛网膜囊肿的适应证及临床疗效。方法回顾性分析2008年1月至2013年1月临床资料完整的81例颅内蛛网膜囊肿手术患者，其中行A术式52例，B术式22例，囊肿全切除者7例。结果按手术方式的不同进行结果统计：行方式A的所有患者中有43例（82.7%）症状明显或完全缓解，5例（9.6%）症状缓解不明显，4例（7.7%）复发；行方式B的所有患者中有18例（81.8%）症状明显或完全缓解，3例（13.6%）症状缓解不明显，1例（4.5%）复发。结论两种手术方式对治疗颅内蛛网膜囊肿均有明显疗效，但青少年患者及囊肿位置较表浅的更适合行方式A；老年患者、囊肿位置较深或体积较大的更适合行方式B。