脊髓栓系综合征患儿的终丝扫描电镜研究  

Study on Scanning Electron Microscope for Filum Terminale of Children with Tethered Cord Syndrome

作　　者：刘福云[1] 李剑峰[1] 季泽娟[1] 郝志伟[1] 曹静[1] 骆晓飞[1] 王志岭[1] 

机构地区：[1]郑州大学第三附属医院小儿骨科,郑州450052

出　　处：《实用儿科临床杂志》2010年第20期1596-1597,1600,共3页Journal of Applied Clinical Pediatrics

基　　金：河南省卫生厅科技攻关计划项目(200703069)

摘　　要：目的通过观察脊髓栓系综合征(TCS)患儿终丝的超微结构,以提高对TCS的病理学认识,为TCS临床诊断与治疗提供可靠依据。方法切除31例TCS患儿终丝,根据终丝直径大小,将其分为2组:22例终丝增粗者(直径≥2 mm)为第一组;9例终丝外观正常者(直径<2 mm)为第二组,取其纵、横切面分别行扫描电镜观察。结果第一组:TCS患儿终丝电镜下典型的改变为胶原纤维、脂肪细胞增多,弹性纤维、网状纤维很稀疏,在某段相对正常的区域还常见到。胶原纤维可表现为不同程度的增粗、扭曲、黏连、融合,排列相对致密,且结构紊乱,有的结构模糊不清,胶原纤维表面有时还会见到一些结晶样物质。第二组:外观正常的终丝亦可见到上述病变,病变程度相对较轻。上述改变可单独出现,亦可伴随出现,很少同时出现。范围:可呈局灶状改变,亦可呈弥散性改变,前者多见。结论终丝三维结构改变,弹性减低,与TCS的发病密切相关。不论终丝外观正常与否,早期手术切断,解除栓系是治疗TCS的必要手段。Objective To improve the understanding in pathology and provide steady proof for diagnosis and treatment of tethered cord syndrome（TCS）,and filum terminalia（FTs） ultrastructure of children with TCS would be researched.Methods Thirty-one fila from children with TCS were sectioned,and divided into 2 groups by their thickness：the first group was thicker FTs（thickness ≥2 mm）,the second group was normal FTs（thickness 2 mm）.Their transversal and longitudinal sections were respectively submitted to scanning electron microscopy analysis.Results In the first group,ultrastructural analysis confirmed the presence of abundant collagen bundles and adipocytes,sparse or invisible elastic and reticular fiber inside FT,but the latter 2 fibers were still visible in the relative normal areas of FT;some abnormalities,such as thickening,distortion,adhesion or fusion to piece,relatively dense and disorderly arrangement at a different degree,were quite common for collagen fiber,and some areas looked blurry and some crystallization appeared occasionally on their surface.In the second group,those changes as mentioned above were still exhibited,but slightly relatively.All the changes mentioned in both groups might exist alone,or concomitantly,rarely simultaneously.Moreover,they could be often seen focally,or disffusely occasionally.Conclusions Low elasticity resulting from FT tri-dimension structure destroyed involved in TCS.Early FT severing is a treatment of choice no matter whether its appearance looks normal.

关 键 词：终丝 脊髓栓系综合征 脊柱裂 儿童 

分 类 号：R726.5[医药卫生—儿科]