两种手术方法治疗Chiari Ⅰ型畸形疗效比较  

Comparison of two kinds of operation methods in the treatment of Arnold-Chiari malformation Ⅰ malformation curative effect

作　　者：艾克拜尔·亚里坤[1] 刘宇利[2] 乌拉别克·毛力提[1] 杨小朋[1] 

机构地区：[1]新疆维吾尔自治区人民医院神经外科,乌鲁木齐830001 [2]新疆医科大学研究生学院,乌鲁木齐830000

出　　处：《国际外科学杂志》2014年第8期533-537,共5页International Journal of Surgery

摘　　要：目的 观察枕后减压硬膜扩大修补＋小脑扁桃体切除与枕后减压硬膜扩大修补两种手术方法治疗ChiariⅠ畸形的疗效.方法 回顾性总结2006年1月-2012年6月新疆维吾尔自治区人民医院神经外科总共97例ChiariⅠ型畸形患者,A组行枕后减压硬膜扩大修补＋小脑扁桃体切除55例;B组行枕后减压硬膜扩大修补42例,对比两组手术效果、空洞消退情况及术后近期并发症发病率.结果 门诊随访6个月～8年,共随访到85例患者,按Tator疗效标准,A、B组优、良、差率比较差异无统计学意义（P＞0.05）,促进空洞消退对比差异无统计学意义（P＞0.05）.A、B两组术后分别有5例、4例患者发生切口感染,术后一过性头痛分别为25例、18例,术后早期脑脊液漏并皮下积液分别为8例、6例,A组死亡1例,总并发症发病率差异无统计学意义（P＞0.05）.结论 枕后减压硬膜扩大修补和枕后减压硬膜扩大修补＋小脑扁桃体切除均是治疗Chiari Ⅰ畸形的可靠方法,两者手术效果无明显差异,而枕后减压硬膜扩大修补手术步骤较少,损伤更小.Objective Observation of Posterior decompression dural enlargement repair ＋ Resection of the cerebellar tonsils and Posterior decompression dural enlargement repair two operation method for treatment of Chiari Ⅰ malformation effect.Methods Retrospectively analyze the clinical data from Jan.2006 to Jun.2012,the department of Neurosurgery,People＇s Hospital of Xinjiang Uygur Autonomous Region for a total of 97 cases of Chiari Ⅰ malformation.Group A was performed in 55 cases for Posterior decompression dural enlargement repair ＋ Resection of the cerebellar tonsils,group B was performed in 42 cases for Posterior decompression dural enlargement repair,and was compared of the effect of the operation,Syringomyelia resolution and the rate of postoperative complications.Results Outpatient follow up for 6 months-8 years,a total of 85 patients were followed up for.According to the criteria of Tator,A,B two groups in the superior,good,poor rate was no significant difference （P ＞ 0.05）.Promote syringomyelia regression had no significant difference（P ＞ 0.05）.A,B two groups of postoperative incision infection were 5 cases and 4 cases,Postoperative transient headache were 25 cases,18 cases.Early postoperative cerebrospinal fliud leakage and subcutaneous effusion were 8 cases,6 cases.One cases died in group A.The total complication rate had no significant difference （P ＞ 0.05）.Conclusions Posterior decompression dural enlargement repair ＋ Resection of the cerebellar tonsils and Posterior decompression dural enlargement repair both are the treatment of Chiari Ⅰ malformation and reliable method.No significant difference exists between the effects of two operation,while the posterior decompression dural enlargement repair operation steps to reduce the damage.

关 键 词：小脑扁桃体下疝畸形 ChiariⅠ畸形 治疗结果 回顾性研究 手术后并发症 

分 类 号：R651.11[医药卫生—外科学]