枕下减压及枕大池重建治疗Arnold-ChiariⅠ型畸形合并脊髓空洞症40例  

The clinical effect of suboccipital decompression combined with occipital large pool reconstruction in the treatment of Arnold-Chiari typeⅠ malformation complicated with syringomyelia

作　　者：韩易[1] 张少军[1] 姜之全[1] 刘后银[1] 

机构地区：[1]蚌埠医学院第一附属医院神经外科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2013年第10期1280-1281,1284,共3页Journal of Bengbu Medical College

摘　　要：目的：探讨枕下减压及枕大池重建治疗Arnold—ChiariI型畸形（ACM—I）合并脊髓空洞症（SM）的效果。方法：显微镜下对40例ACM—I合并SM患者行后颅窝小骨窗枕下减压，改善脑脊液循环，并枕大池重建。结果：术后复查MtlI示小脑扁桃体上抬至枕骨大孔水平，枕大池较前扩大。随访3～30个月，无死亡病例，临床症状改善35例，无变化5例，有效率87．50％；脊髓空洞缩小者33例，无变化7例，有效率82．50％。结论：枕下减压及枕大池重建是治疗ACM—I合并SM的有效方法。Objective：To explore the effects of suboccipital decompression combined with occipital large pool reconstruction in the treatment of Aruold-Chiari type [ malformation（ACM- I ） complicated with syringomyelia（SM）. Methods：Forty patients were treated with suboccipital decompression through posterior fossa small bone window,improving eerebralspinal fluid circulation and reconstructing occipital large pool under the microscope. Results ： After operation, MRI showed the cerebellar tonsil was above the level of foramen magnum and cisterua magna expanded. All patients were followed up for 3 to 30 months. No death case, the clinical symptoms improvement in 35 cases and no change in 5 cases were found,the effective rate was 87.50%. Syringomyelia reduction in 33 cases and no change in 7 cases were found, the effective rate was 82.50%. Conclusions ： Suboccipital decompression combined with occipital large pool reconstruction is an effective way for treating ACM- I cornplicated with SM.

关 键 词：Arnold-ChiariⅠ型畸形 脊髓空洞症 枕下减压 枕大池重建 

分 类 号：R742.84[医药卫生—神经病学与精神病学] R744.4[医药卫生—临床医学]