颅内蛛网膜囊肿-腹腔分流术后疗效长期随访分析

Analysis about the result of cystoperitoneal shunt for the treatment of arachnoid cysts in children

目的探讨囊肿～腹腔分流术治疗儿童颅内蛛网膜囊肿的疗效。方法回顾我院2003年1月至2005年1月62例囊肿分流手术治疗颅内蛛网膜囊肿患者，随访其CT及MRI结果，对其疗效进行了长期随访。结果62例囊肿中46例（74％）位于侧裂，8例（13％）位于大脑凸面，8例（13％）位于幕下。所有患者接受了蛛网膜囊肿-腹腔分流术。术后平均随访时间6．5年（6—8年），59例患者影像资料显示囊肿大部消失或完全消失，占95％。与分流手术相关的并发症有16例，其中8例出现良性颅高压症状。结论囊肿-腹腔分流术是一种简单有效、安全的治疗方法，但应严格选择其手术适应证，对术后可能的并发症也应予以充分的重视。

Objective To evaluate the clinical significance of cystoperitoneal shunt in surgical management of intracranial arachnoid cyst. Methods Between January 2003 and January 2005, 62 patients with arachnoid cysts underwent cystoperitoneal shunt in our institute. All patients were evaluated with CT or MRI and had regular follow-up examinations. Results 46 patients were （74%） cysts within the sylvian fissure, 8 patients （ 13% ） were in the cerebral convexity, 8 patients （ 13% ） were infratentorial. Cystoperitoneal shunt was placed in all patients; Follow-up imaging studies showed that the size of arachnoid cysts was reduced in 59 patients （95%） during a mean postoperative follow-up period of 6. 5 years （range, 6 to 8 years）. Although a cystoperitoneal shunt was the effective method for early achieving obliteration, there were 16 shunt-related complications, including 8 patients suffered from typical symptom of pseudotumor cerebri with a shunt malfunction suggesting shunt dependency. Conclusions Shunt placement is a safe and effective surgical treatment of symptomatic arachnoid cysts in children. Efforts should be made to decrease the complication of the shunt of araehnoid cysts.