手术治疗颅内蛛网膜囊肿112例分析

An analysis of 112 patients with intracranial arachnoid cysts underwent surgery

目的探讨颅内蛛网膜囊肿(IAC)患者的手术指征。方法回顾性分析112例IAC患者的临床资料。结果112例患者中有66例脑脊液压力高于正常,CT蛛网膜下腔-脑池造影(CTC)显示非交通性IAC患者88例。79例患者选择了手术治疗,并随访半年以上,57例患者症状好转,40例复诊CT见囊肿缩小,7例囊肿消失。术前腰穿脑脊液压力及临床症状是决定手术的主要影响因素(P<0.05),是否手术与患者年龄和术前CTC检测囊肿是否通畅无相关关系(P>0.05),但术前CTC检测囊肿是否通畅是预测术后患者症状能否缓解的相关因素(P<0.05)。结论术前有明确临床症状和脑脊液压升高是IAC患者绝对手术指征,CTC可以作为患者术后症状能否缓解的预测指标。

Objective To investigate the indications of surgery for the patients with intracranial arachnoid cyst(IAC).Methods The data of 112 patients with IAC underwent surgery were retrospectively analyzed.Results Of 112 patients,the cerebrospinal fluid(CSF)pressure was higher than normal in 66 cases.CT subarachnoid cisternography(CTC)showed that 88 cases were with noncommunicated IAC.Surgical treatment was performed in 79 patients,who were followed up for more than 6 months.The symptoms of 57 cases were improved.CT examination showed that the cysts were reduced in 40 patients and disappeared in 7 cases.The CSF pressure and clinical symptoms were the significant factors to be the indications for the surgery in IAC patients(P<0.05),which were not related to age and the patency of cysts on CTC(P>0.05).But communicated IAC predicted the remission of the symptoms after operation(P<0.05).Conclusion The increased CSF pressure and definite clinical symptoms are the absolute indications for the surgery in IAC patients.CTC can be taken as a predictor for the remission of clinical symptoms after operation.