儿童Rathke囊肿的临床特点及显微外科治疗

Microsurgery for Rathke's cleft cysts in children

目的分析、探讨儿童Rathke囊肿的临床特点及其显微外科治疗。方法回顾性分析了我院1993年6月至2004年3月间经手术及病理证实的20例儿童Rathke囊肿病例。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3例,经额开颅17例;全切8例,近全切5例,大部切除7例。结果本组患儿术后随访5个月至8年,绝大部分患儿症状消失或改善,且均无复发。其中,内分泌异常表现明显减轻或消失者14例,占(14/18)77.8%;头痛症状消失者10例,占(10/12)83.3%;视觉障碍患儿的视力均得到改善。结论儿童Rathke囊肿术前确诊困难,影像学检查无特异性。对于儿童症状性Rathke囊肿,显微手术可明确诊断、改善症状,患儿预后均良好。显微外科手术是治疗本病的有效方法。

Objective To evaluate the long-term results of microsurgery for Rathke's cleft cysts in children. Methods Clinical data of microsurgery for Rathke's cleft cysts in 20 children in Tiantan Hospital between 1993 and 2004 were retrospectively analyzed. All patients were diagnosed by the pathological examination. The main clinical manifestations included pituitary dysfunction, visual disturbance and headache. All patients received microsurgical operations through transfrontal (n=17) or transsphenoidal approaches (n=3). Tumors were totally removed in 8 cases and subtotally in 12 cases. All patients underwent follow-up from 5 months to 8 years.Results During the follow-up period, no recurrence had been noted. Pituitary dysfunction in 14 cases ( 77.8%) was dissolved or significantly relieved, headache in 10 cases ( 83.3%) was resolved, and impaired vision in all patients was improved. Conclusions The satisfactory results can be gained by microsurgical operations for children with Rathke's cleft cysts.