盆腔内骶前脊膜膨出的诊断和治疗——病例报道及文献复习

Diagnosis and treatment of anterior sacral meningocele:case report and review of literature

目的 探讨罕见的盆腔内骶前脊膜膨出的临床表现、诊断及手术方法。方法 报道 1例并回顾国内 7例个案，结合国外文献进行分析。结果 包括本例在内的 8个国内病例中，男 3例，女 5例，年龄从 5个月至 52岁，平均 14.9岁。所有病例主要表现为便秘和排尿困难， B超、 CT或 MR均可发现盆腔巨大囊肿，其中 2例并发畸胎瘤， X片提示骶椎前裂，脊碘造影可见造影剂进入囊肿腔。 8例均经手术治愈。结论 根据临床特点、骶骨拍片、 B超及脊碘造影可确诊， CT及 MR更具指导意义。单纯脊膜膨出以骶后入路手术安全方便，并发畸胎瘤者需经腹手术。

Objective To report anterior sacral meningocele in pelvic cavity and to discuss its clinical features,diagnostic procedures and operative approach.Methods 1 case was reported and 7 single cases reported in China were reviewed.Results There were 3 cases male and 5 cases female.The age of all patients were ranged from 5 months to 52 years old,the mean age was 14.9 years old.The most common symptoms were that of constipation and dysuria.A cystic mass was demonstrated by B－ ultrasonic or CT and MR examinations in pelvic cavity.Teratoma in pelvic cavity was discovered simultaneously in 2 cases.X－ ray showed the sacral spinal bifida.Myelography revealed the contrast medium into the cystic cavity.All patients had been cured by operation.Conclusion According to its clinical features,sacrum X－ ray,B－ ultrasonic and myelography,the diagnosis of anterior sacral meningocele can be made.CT or MR is a more significant procedure of diagnosis.Transsacral approach was safe and convenient to simple meningocele.Transabdominal approach may be necessary to th e patients with simultaneous teratoma.