Chiari畸形合并脊髓空洞症后颅窝扩大成形手术方式探讨  

Surgical treatment of Chiari malformation accompanied by syringomyelia

作　　者：张云东[1] 谢家洪 周济[1] 沈光建[1] 任明亮[1] 顾小红[3] 

机构地区：[1]第三军医大学大坪医院野战外科研究所神经外科 [2]万州区中西医结合医院,重庆400042 [3]第三军医大学大坪医院野战外科研究所老年科,重庆400014

出　　处：《重庆医科大学学报》2010年第3期424-426,共3页Journal of Chongqing Medical University

基　　金：第三军医大学大坪医院临床研究项目(编号:2007XG071)

摘　　要：目的:探讨扩大重建后颅窝不同大小减压骨窗对治疗Chiari畸形合并脊髓空洞症脊髓功能恢复的作用。方法:87例Chiari畸形合并脊髓空洞症病人行枕大池成形术,其中51例行后颅窝大骨窗减压与36例行后颅窝小骨窗减压手术治疗效果分析,定期随访。结果:术后大骨窗减压51例患者中,22(43.1%)例症状改善明显,10例症状无明显变化,5例病情加重;小骨窗减压36例患者中,28(77.8%)例症状改善明显,3例病情稳定。小骨窗减压术后症状改善明显、远期效果稳定。结论:后颅窝骨窗减压硬脑膜修补术是治疗Chiari的有效方法,小骨窗减压具有创伤小、症状改善明显和疗效稳定的优势。Objective：To study the different modus operandi of posterior fossa decompression on function recovery of spine cord in patients with Chiari malformation and syringomyelia.Methods：Of 87 patients with Chiari malformation and syringomyelia,51 patients were selected and big craniectomy was performed in all cases.The effects of big craniectomy in 51 patients and mini craniectomy in 36 patients were compared.Results：Among the 51 patients,22 patients（43.1%） improved significanly in their clinical symptoms,10 cases were stabilized,and 5 cases deteriorated.Among the 36 patients,28 patients（77.8%） improved significanly in their clinical symptoms,and 3 cases were stabilized.Conclusion：Surgical treatment may fully ameliorate the clinical syndromes.Mini craniectomy and expansile reconstruction of posterior fossa is a preferred surgery for the treatment of ChiariⅠmalformation.

关 键 词：CHIARI畸形 脊髓空洞症 后颅窝扩大减压术 

分 类 号：R651.11[医药卫生—外科学]