脊髓纵裂手术治疗的疗效  

Treatment of diastematomyelia by operation

作　　者：彭军[1] 兰宾尚[2] 樊李瀛[2] 江振华[1] 

机构地区：[1]广州医学院附属深圳沙井医院骨科,深圳518104 [2]西安交通大学医学院第二附属医院骨二科,西安710004

出　　处：《中国矫形外科杂志》2008年第17期1295-1297,共3页Orthopedic Journal of China

基　　金：陕西省科技计划项目资助课题[编号:2004K11-G2(4)]

摘　　要：[目的]探讨脊髓纵裂手术治疗效果。[方法]对1978年5月-2006年1月收治的有完整资料的121例单管型及双管型脊髓纵裂手术及非手术治疗的病例进行回顾性分析，并通过临床神经功能评分及胫后神经皮层体感诱发电位（PTNCSEP）P40波峰监测，评价其手术治疗的疗效。[结果]双管型脊髓纵裂通过手术后观察和6个月-15年（平均2年6个月）的随访发现，临床神经功能评分及PTNCSEP术后有明显改变，尤其是疼痛为主诉的患者恢复最为明显，手术的总有效率可达86％；单管型脊髓纵裂手术前后无明显变化。[结论]双管型脊髓纵裂脊髓损害重，且呈进行性加重，精细的手术治疗可以使大多数患者症状缓解，终止神经进行性损伤，确诊后应尽早手术；单管型脊髓纵裂脊髓损害轻，不需手术探查。[ Objective] To evaluate the clinical treatment results for diastematomyelia treated by operation. [ Method] Data from patients with diastematomyelia admitted to our hospital from May 1978 to January 2006 were reviewed. According to the classification, there were single - tube in 25 and double - tube in 96 patients. One hundred and two patients with diastematomyelia were treated by operation and ninteen by conservative treatment. The clinical results were retrospectively analyzed according to scoring neural function and monitoring the peak P40 of posterior trivial nerve cortical somatosensory evoked potential （ PTNCSEP） before and after treatment. [ Result ] The total operative effective rate of double - tube diastematomyelia amounted to 86% during a follow -up period of 6 months to 15 years, more significant inpatients with pain. The scores of neural function and PTNCSEP were significantly improved. But patients with single -tube diastematomyelia had no obvious change after operation. [ Conclusion] The spinal cord is damaged severely in double -tube diastematomyelia and gradually aggravated. Operation can get symptomatic relief in many patients and terminate spinal cord lesion. So operation should be performed as soon as the di- agnosis is made. The spinal cord is damaged slightly in single -tube diastematomyelia and surgery is not indicated.

关 键 词：脊髓纵裂 手术 疗效 

分 类 号：R651.2[医药卫生—外科学]