单纯性脊髓空洞分流术远期临床疗效分析  

Clinical effect of syringopleural shunt of patients with simple syringomyelia

作　　者：汪建军[1] 宁同波[2] 赵峰 范晓勇[1] 孟祥靖[1] 

机构地区：[1]山东省千佛山医院神经外科,济南250014 [2]威海市文登中心医院神经外科 [3]德州市临邑县中医院神经外科

出　　处：《中国综合临床》2014年第11期1141-1143,共3页Clinical Medicine of China

基　　金：山东省自然科学基金资助项目（ZR2010HL010）

摘　　要：目的 单纯性脊髓空洞症患者行脊髓空洞胸腔分流（SPS）和脊髓空洞蛛网膜下腔分流（SSS）手术方式的临床疗效评价.方法 脊髓空洞症患者28例,其中行SPS 18例,SSS 10例,对其疗效进行评价.结果 所有患者术后3个月左右复查MRI检查脊髓空洞腔明显缩小;术后早期（48 h内）9例SPS术式患者、4例SSS患者在术后早期MRI均显示空洞范围缩小,SPS术式病例中感觉症状改善15例（83.3％）,无明显改善1例（5.5％）,加重或其他部位出现感觉异常1例（5.5％）,患侧感觉改善健侧出现感觉异常1例（5.5％）;SSS术式病例中感觉症状改善8例（80.0％）,无明显改善1例（10.0％）,加重或其他部位出现感觉异常1例（10.0％）.SPS术式术后4例患者出现少量气胸,肺压缩比均小于5％,均未行手术干预处理.所有患者均未出现分流管堵塞、感染和胸腔积液等症状.结论 单纯性脊髓空洞症伴有症状患者适合行空洞分流手术,相对于蛛网膜下腔分流,我们认为胸腔分流有一定的优势,但是需要长期的大宗手术病例随访资料证实.Objective To evaluate the clinical effect of the simple syringomyelia patients with syringopleural shunt （SPS） and syringosubarachnoid shunt （SSS）.Methods Twenty-eight patients with syringomyelia were selected as our subjects.Of which,18 patients were operated with SPS and 10 cases were with SSS.The therapy effect was compared between groups.Results All patients were checked with MRI 3 months after the operations and showed that syrinx cavity was significantly narrow of all patients.At early stage （48 h） after surgery 9 cases in SPS and 4 cases in SSS were showed the decrease syrinx cavity.Among patients with SPS,15 cases （83.3％） had the symptoms and signs improved,1 case （5.5％） withno changes,1 case （5.5％） with worse effect,and 1 cases（5.5％） occurred the tethered spinal cord.Meanwhile,among,patients with SSS,8 cases（80.0％） had the symptoms and signs improved,1 case（10.0％） with no changes,and 1 case （10.0％） with worse effect.There were 4 patients with pneumothorax in SPS group after operations,and the lung compression ratios were less than 5％.These cases were not taken any special treatment for the pneumothorax.All patients in two groups had not been infected and pleural effusions.No cases had taken the tube plugging.Conclusion The simple syringomyelia patients with the spine injury should take the cavity shunt.The SPS has some advantages because it can provide the partly negative pressure.But it should be certified by more cases and a long-time follow up.

关 键 词：脊髓空洞症 脊髓空洞胸腔分流术 脊髓空洞蛛网膜下腔分流术 

分 类 号：R651.2[医药卫生—外科学]