微创治疗透明隔囊肿的临床研究

Clinical study on minimally invasive treatment of septum pellucidum cyst

目的神经内镜造瘘术与立体定向穿刺术分流治疗透明隔囊肿的疗效对比研究。方法应用神经内镜系统经侧脑室行透明隔囊肿造瘘15例,立体定向技术行透明隔囊肿穿刺分流术22例。结果所有病例术后1周复查头颅CT,两组有26例囊肿明显缩小(囊肿缩小>50%),多数患者症状有不同程度改善;3个月后回访神经内镜手术组,CT显示13例患者(86.7%)囊肿明显缩小,自觉症状改善者有增加,该组患者1例颅内出血,经保守治疗后完全治愈;立体定向手术组患者,CT显示10例患者(47.6%)囊肿明显缩小,自觉症状改善者亦有增加,1例失访,本组患者无并发症。结论神经内镜下透明隔囊肿造瘘治疗透明隔囊肿的近期疗效与立体定向穿刺术差异无显著性,但后者的并发症发生几率可能较小。

【Objective】To compare the curative effect between two treatments of septum pellucidum cyst, neuroendoscopic ventriculostomy and stereotactic puncture and shunt treatment. 【Methods】15 patients with septum pellucidum cyst were treated by neuroendoscopic ventriculostomy, and other 22 patients were given a septum pellucidum cyst shunt via stereotactic puncture. 【Results】Septum pellucidum cysts in 26 patients （both in two groups） obviously shrank （decreased 50%）, which were all scanned by CT 1 week after operation, and different levels of improvement in symptoms was detected in most patients. 3 months later after neuroendoscopic ventriculostomy, septum pellucidum cysts in 13 patients （86.7%） markedly shrank, and more patients＇ symptoms were improved. Only one patient presented intracranial hemorrhage, but was cured via conservative treatment. In group of stereotaxy, septum pellucidum cysts in 10 patients （47.6%） diminished and also more patients felt good 3 months later after operation. Except one patient failed to follow, no complications in patients were found.【Conclusion】There are no significant distinctions between two treatments of septum pellucidum cyst in the short-term effects, but the incidence of complications may be lower in group of stereotaxy.