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目的探讨儿童鞍上蛛网膜囊肿的传统开颅手术及内镜下第三脑室底造瘘手术的治疗方法及疗效的比较。方法回顾分析2001年8月至2005年8月北京天坛医院收治的儿童鞍上蛛网膜囊肿患者44例,术前采用MRI明确诊断,分别采取传统开颅手术切除囊肿或者内镜下囊肿切开第三脑室底造瘘术,术后定期随访,观察疗效结果所有44例患者手术顺利,术后症状好转,MRI检查提示囊肿和脑室缩小,导水管通畅,无手术死亡,术后平均随访23个月,两组术后并发症发生率差异无统计学意义(P>0.05)。结论与传统的开颅囊肿剥除术相比,神经内镜手术具有创伤小、住院时间短、恢复快的独特优势,有望成为鞍上囊肿的首选治疗。
Objective To investigate the treatment and efficacy of traditional craniotomy on the suprasellar arachnoid cyst and endoscopic third ventriculostomy. Methods A retrospective analysis of 44 patients with supraralid arachnoid cysts admitted to Beijing Tiantan Hospital from August 2001 to August 2005 was performed. The patients were diagnosed by MRI before operation. The patients underwent craniotomy or endoscopic cyst excision Third ventricle fistula, regular follow-up after operation to observe the efficacy of the results All 44 patients underwent a successful operation, the symptoms improved, MRI examination showed that cysts and ventricles were reduced, the aqueduct was unobstructed, with an average follow-up of 23 months There was no significant difference in the incidence of postoperative complications between the two groups (P> 0.05). Conclusion Compared with the traditional cyst excision, endoscopic neurosurgery has the unique advantages of less trauma, shorter hospital stay and quicker recovery, and is expected to be the first choice treatment for suprasellar suprasellar cyst.