显微外科治疗颅内蛛网膜囊肿35例疗效分析

ANALYZE THE CLINICAL EFFECTS OF MICROSURGICAL TREATMENT OF INTRACRANIAL ARACHNOID CYSTS IN 35 CASES

目的探讨显微手术治疗颅内蛛网膜囊肿(IAC)的不同方法及其临床疗效。方法回顾性分析显微手术治疗颅内蛛网膜囊肿35例患者,其中开颅囊肿全切除11例,囊肿部分切除-脑池开放术16例,开颅囊腔-脑池(或蛛网膜下腔)置管内引流术8例。结果手术过程均较顺利,术后临床症状均有不同程度改善,未出现严重并发症,术后平均随访3个月～3年,复查头颅CT发现囊肿基本消失或有不同程度缩小,神经症状消失或明显好转。结论显微外科治疗颅内蛛网膜囊肿,采用不同手术方式均取得较好的效果,开颅囊肿全切除术争取囊肿脏层剥离及壁层全切疗效最佳,囊肿部分切除-脑池开放术较开颅囊腔-脑池(或蛛网膜下腔)置管内引流术症状改善,打通囊肿与周围脑池及蛛网膜下腔是提高临床疗效的关键。

Objective To investigate the different methods and clinical effects of microsurgical treatment of intracranial arachnoid cysts. Methods Thirty five cases of microsurgical treatment of intracranial arachnoid cysts were analyzed retrospectively, among which eleven cases were treated with the method of total removal of arachnoid cyst, sixteen cases with partial removal of arachnoid cyst- brain cisterns opened method, and eight cases with cysts fenestration- brain cisterns （or subarachnoid space ） shunting method. Results The operational process went smoothly, and after operation clinical syndromes ameliorated to a varying degree, with no severe complication. Follow - up was performed for three months to three years ; and review of the cysts by CT indicates that the cysts were disap- pearing or diminishing to some degree, neural - syndromes vanishing or turning better manifestly. Conclusion Mi- crosurgical treatment of intracranial arachnoid cysts resuhed in better effects by way of different operational methods： the method of total removal of intracranial arachnoid cysts helped to peel off the cyst laminavisceralis and totally re- move wall - layers, giving rise to best results ; compared with cysts fenestration - brain cisterns （ or subarachnoid space） shunting method, partial removal of arachnoid cyst -brain cisterns opened method got better results ; to cleave cyst, brain pool and subarachnoid space is the key to improve clinical effects.