摘要
目的 :提高Rathke裂囊肿的诊断和治疗水平。方法 :回顾性研究 1993年到 2 0 0 2年 ,在我院经蝶手术的 33例Rathke裂囊肿 ,术前头痛占 78 8% ,垂体功能紊乱占 6 2 4 % ,视力减退 2 7 3%。X线平片蝶鞍扩大者占15 2 % ,CT呈高密度者占 6 1 5 % ,MRIT1像显示 6 3 6 %的囊肿呈高信号 ,15 2 %等信号 ,12 1%低信号 ,9 1%混合信号 ,囊肿均不被强化。 33例均经蝶入路手术切除病变。结果 :术后 10 0 %患者的视力改善 ,84 6 %头痛消失或减轻 ,72 7%月经恢复 ,6 6 7%乏力感消失 ,5 0 %体重明显减轻。结论 :Rathke裂囊肿垂体功能紊乱发生率比人们估计为高 ;如发现鞍内一囊性结构 ,CT显示为高密度 ,MRIT1像表现为高或低信号 ,强化后无增强 ,应考虑为Rathke裂囊肿 ;绝大多数Rathke裂囊肿可经鼻蝶入路清除病灶 ,并能有效地改善临床症状及垂体功能 ;积极手术治疗 ,即使是病人有轻微的症状和体征 ,以免发生不可逆转的垂体功能低下。
Objective:To raise the diagnos and treatment level of Rathke′s cleft cysts.Methods:We retrospectively reviewed data collected on Rathke′s cleft cysts between 1993 and 2002, 33 patients presenting symptoms were treated by transsphenoidal surgery. Before the operation, headache was present in 78.8%, pituitary dysfunction in 62.4% and visual interference in 27.3%,enlargement of the sella turcica on plain x-rays in 15.2%. CT showed high density lesion in 61.5%,and MRI showed high intensity on T1 weighted images lesion in 63.6%,iso-intensity in 15.2%, low intensity in 12.1%,and others in 9.1% and no enhancement in all of cases. All patients were treated by a transsphenoidal surgery.Results: Postoperative visual disturbance improved in 100% of patients,headaches were resolved in 84.6%,Amenorrhea recovered or improved in 72.7%.Conclusions: Results of the present study indicate: 1)The incidence of pituitary dysfunction in patients with Rathke′s cleft cyst is higher than suspected.2).When a non-enhancing cyst-like structure in the sella turcica with CT showed high density and MRI showed high intensity or low intensity on T1 is demonstrated,the possibility of Rathke′s cleft cyst should be considered.3).Most Rathke cleft cysts can be treated by a transsphenoidal surgery and in most cases surgical intervention improves pituitary function and the clinical status of the patient.4).Surgical treatment is recommended even when the patient has only mild symptoms or signs, including pituitary dysfunction, to prevent irreversible panhypopituitarism.
出处
《军医进修学院学报》
CAS
2004年第1期12-14,共3页
Academic Journal of Pla Postgraduate Medical School
