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目的分析、探讨儿童Rathke囊肿的临床特点及其显微外科治疗。方法回顾性分析了我院1993年6月至2004年3月间经手术及病理证实的20例儿童Rathke囊肿病例。患儿的主要临床表现为内分泌异常、视觉障碍、头痛。所有患儿均接受了显微外科手术治疗,其中经蝶手术3例,经额开颅17例;全切8例,近全切5例,大部切除7例。结果本组患儿术后随访5个月至8年,绝大部分患儿症状消失或改善,且均无复发。其中,内分泌异常表现明显减轻或消失者14例,占(14/18)77.8%;头痛症状消失者10例,占(10/12)83.3%;视觉障碍患儿的视力均得到改善。结论儿童Rathke囊肿术前确诊困难,影像学检查无特异性。对于儿童症状性Rathke囊肿,显微手术可明确诊断、改善症状,患儿预后均良好。显微外科手术是治疗本病的有效方法。
Objective To analyze and discuss the clinical features and microsurgical treatment of Rathke cysts in children. Methods A retrospective analysis of our hospital from June 1993 to March 2004 confirmed by surgery and pathology in 20 cases of children with Rathke’s cyst. The main clinical manifestations of children with endocrine abnormalities, visual impairment, headache. All children underwent microsurgical treatment. Among them, 3 had transsphenoidal surgery and 17 had craniotomy; 8 had undergone complete resection, 5 had undergone complete resection, and 7 had undergone resection. Results This group of children were followed up for 5 months to 8 years, the majority of children with symptoms disappeared or improved, and no recurrence. Among them, 14 patients (14/18) with a significant decrease or disappearance of endocrine abnormalities accounted for (14/18) 77.8%; 10 patients (10/12) disappeared with headache symptoms disappeared; visual acuity was improved in children with visual impairment. Conclusion Children with Rathke cyst are difficult to diagnose before surgery, and imaging examination is not specific. For children with symptomatic Rathke cysts, microsurgery can be a clear diagnosis, improve symptoms, children with good prognosis. Microsurgery is an effective way to treat this disease.