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目的 :探讨神经内镜下经蝶手术治疗鞍区症状性Rathke囊肿的效果、手术技巧和术后并发症。方法 :回顾性分析2010年1月—2015年12月本科收治的22例鞍区症状性Rathke囊肿患者的临床资料。临床主要表现为头痛、视力下降及内分泌症状,均采用神经内镜经蝶入路手术。22例患者术中均完全清除囊液,大部分切除囊壁。结果:本组无死亡病例,术后随访4~60个月,患者临床症状均有所改善。术后出现一过性尿崩5例,永久性尿崩1例。术后有2例复发,其中1例经再次手术后治愈。结论:神经内镜经蝶手术创伤小,术后并发症少,疗效满意,是治疗鞍区Rathke囊肿的理想方法。
Objective: To investigate the efficacy, surgical skills and postoperative complications of endoscopic transsphenoidal surgery for the treatment of symptomatic Rathke’s cysts in the sellar region. Methods: The clinical data of 22 patients with symptomatic Rathke cysts in the sellar region from January 2010 to December 2015 were analyzed retrospectively. Main clinical manifestations of headache, decreased visual acuity and endocrine symptoms, are treated by endoscopic transsphenoidal surgery. Twenty-two patients underwent complete cyst fluid removal and most resection of the cyst wall. Results: There were no deaths in this group. The patients were followed up for 4 to 60 months and the clinical symptoms were improved. Postoperative transient urethral collapse in 5 cases, 1 case of permanent diabetes insipidus. There were 2 cases of recurrence after surgery, of which 1 case was cured after reoperation. CONCLUSIONS: Endoscopic transsphenoidal surgery is less invasive and less postoperative complications with satisfactory results. It is an ideal method for the treatment of Rathke’s cysts in the sellar region.