[1]王　飞　孙　涛　周玮林　夭晓燕　余化霖.外侧裂蛛网膜囊肿分型及神经内镜造瘘手术治疗[J].中国临床神经外科杂志,2016,(04):203-205.[doi:10.13798/j.issn.1009-153X.2016.04.004]
　WANG Fei,SUN Tao,ZHOU Wei-lin,et al.Classification and neuroendoscopic managements of Sylvian fissure arachnoid cysts[J].,2016,(04):203-205.[doi:10.13798/j.issn.1009-153X.2016.04.004]
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外侧裂蛛网膜囊肿分型及神经内镜造瘘手术治疗()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2016年04期
页码:
203-205
栏目:
论著
出版日期:
2016-04-25

文章信息/Info

Title:
Classification and neuroendoscopic managements of Sylvian fissure arachnoid cysts
文章编号:
1009-153X（2016）04-0203-03
作者:
王　飞　孙　涛　周玮林　夭晓燕　余化霖
650032 昆明，昆明医科大学第一附属医院神经外二科
通讯作者：孙　涛，E-mail：neurosurgeonwf@aliyun.com
Author(s):
WANG Fei;  SUN Tao;  ZHOU Wei-lin;  YAO Xiao-yan;  YU Hua-lin.
The Second Department of Neurosurgery, The First Affiliated Hospital, Kunming Medical University, Kunming 650032, China
关键词:
外侧裂蛛网膜囊肿; 神经内镜造瘘术; 分型; 疗效
Keywords:
Sylvian fissure arachnoid cysts;  Neuroendoscope;  Classification;  Surgery
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2016.04.004
文献标志码:
A
摘要:
目的 探讨外侧裂蛛网膜囊肿（SACs）的分型方法及其相应神经内镜造瘘手术方式的疗效。方法 按SACs内侧囊壁与外侧裂的关系分为三型：Ⅰ型，SACs内侧囊壁位于外侧裂外1/3；Ⅱ型，SACs内侧囊壁位于外侧裂中1/3；Ⅲ型，SACs内侧囊壁位于外侧裂内1/3或邻近脚间池。Ⅰ型和Ⅱ型采用神经内镜囊肿-外侧裂造瘘术，Ⅲ型采用神经内镜囊肿-脚间池造瘘术。结果 本组收集SACs 34例，Ⅰ型4例，Ⅱ型9例，Ⅲ型21例。所有手术过程顺利，术后病理检查结果为IACs。术后随访14~38个月，平均20.2个月，SACs体积缩小率、症状缓解率及术后硬膜下积液或血肿发生率分别为68%、38%和12%。Ⅲ型SACs术后体积缩小率和症状缓解率均明显优于Ⅰ型和Ⅱ型（P<0.05）；ⅲ型硬膜下积液或血肿发生率均明显低于ⅰ型和ⅱ型（>P<0.05）。>结论 Ⅲ型SACs应首选神经内镜囊肿-脚间池造瘘术，Ⅰ型和Ⅱ型的囊肿-外侧裂造瘘术效果不佳可能与患侧外侧裂发育不良有关。
Abstract:
Objective To guide the neuroendoscopic surgery for Sylvian fissure arachnoid cysts (SFACs) by proposing new SFACs classification principle. Methods Thirty-four SFACs were classified as three types including typeⅠ(n=4), in which the inner wall of SFACs located at the lateral one third part of Sylvian fissure, type Ⅱ(n=9), in which the inner wall located at the middle one third part of Sylvian fissure and type Ⅲ (n=21), in which the inner wall located at the medial one third part of Sylvian fissure or stretched to the cisterna interpeduncularis. Neuroendoscopic cyst-Sylvian fissure fenestration was applied to typeⅠand Ⅱ SFACs and neuroendoscopic cyst-interpeduncular cistern fenestration to type Ⅲ SFACs. Results Mean period of follow-up was 20.2 months in all the patients. The rates of cyst deflation, clinical symptoms improvement and subdural effusion or hematoma occurrence were 68%, 38% and 12% respectively in all the patients. The curative effect of the surgery including cyst deflation and clinical symptoms improvement was significantly better in the patients with type Ⅲ SFACs than that in the patients with typeⅠor Ⅱ SFACs (P<0.05). the="" subdural="" effusion="" or="" hematoma="" occurrence="" rate="" was="" significantly="" lower="" in="" patients="" with="" type="" ⅲ="" sfacs="" than="" that="" typeⅰor="" ⅱ="" after="" operation="" (P<0.05).>Conclusions The neuroendoscopic cyst-cistern fenestration should be considered first in the patients with type Ⅲ SFACs and the most optimal surgical treatment should be further studied in the patients with typesⅠand Ⅱ SFACs.

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备注/Memo

备注/Memo:
基金项目：国家自然科学基金（81260182；81560206）；云南省科技厅联合专项研究基金（2012FB036；2012FB037）
更新日期/Last Update: 2016-04-30