经鼻蝶显微手术切除Rathke囊肿62例临床分析

The clinical analysis of 62 cases of Rathke＇s cleft cysts treated by microsurgical transsphenoidal surgery

目的 讨论Rathke囊肿的术前诊断和经鼻蝶显微手术疗效。方法回顾性分析2011年1月至2015年5月在中山大学附属第一医院住院的62例经手术和病理证实的垂体Rathke囊肿患者的临床资料。所有病例均接受经鼻蝶显微手术。结果术前第一诊断及考虑垂体Rathke囊肿50例，误诊12例。术后随访6～12个月，患者的症状有不同程度改善，有1例复发，无死亡病例及严重并发症。结论Rathke囊肿的诊断需要结合患者的临床症状、内分泌学检查和影像学资料等多方面综合考虑：经鼻蝶显微手术切除Rathke囊肿安全、有效。

Objective To discuss the preoperative diagnosis and the effect of microsurgieal transsphenoidal surgery of pituitary Rathke＇s cleft cysts. Methods Retrospective analysis was performed from January,2011 to May,2015 on 62 cases of Rathke＇s cleft cyst which confirmed by surgery and pathology at the First Affiliated Hospital of Sun Yat-sen University. Sixty-two cases were performed by the surgery of transsphenoidal approach. Results There were 50 cases with a correct preoperative diagnosis of and consider Rathke＇s cleft cyst, 12 cases of misdiagnosis. Postoperative follow-up was performed within 6-12 months, and the patient＇s clinical symptoms were improved in different degrees, 1 case of recurrence, no deaths and serious complications. Conclusion The diagnosis of Rathke＇s cleft cyst need for comprehensive considerations fi＇om many aspects, and the improvement of diagnosis rate base on the clinical features, endocrine examination, and imaging data. The mierosurgieal transsphenoidal surgery is safe and effective treatment for Rathke＇s cleft cyst.