三种手术方法治疗Chiari Ⅰ畸形并脊髓空洞的疗效对比  

Three kinds of operation method in the treatment of Chiari Ⅰ malformation with syringomyelia curative effect contrast

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

机构地区：[1]新疆维吾尔自治区人民医院,830001 [2]新疆医科大学研究生学院

出　　处：《中华神经外科杂志》2014年第12期1271-1274,共4页Chinese Journal of Neurosurgery

摘　　要：目的 观察三种手术方法治疗ChiariⅠ畸形并脊髓空洞疗效.方法 总结新疆维吾尔自治区人民医院神经外科2005年6月至2012年6月133例ChiariⅠ畸形并脊髓空洞患者,A组行单纯骨性减压20例;B组行骨性减压＋硬膜扩大修补65例;C组行骨性减压＋硬膜扩大修补＋小脑扁桃体切除48例.对比三组手术效果、脊髓空洞消退情况及术后近期并发症发生率.结果 门诊随访6个月至9年,共随访到118例患者,按Tator疗效标准,A、B、C三组优、良、差率比较的差异有统计学意义（P＜0.05）,脊髓空洞消退对比的差异有统计学意义（P＜0.05）,B和C组手术效果相似,均优于A组.A、B、C三组术后切口感染分别为1例、2例、1例,术后一过性头痛分别为6例、30例、23例,术后早期脑脊液漏并皮下积液分别为0例、8例、6例,C组死亡1例,总并发症的差异无统计学意义（P＞0.05）.结论 骨性减压＋硬膜扩大修补是治疗ChiariⅠ畸形并脊髓空洞可靠方法之一,它与骨性减压＋硬膜扩大修补＋小脑扁桃体切除手术疗效相当,优于单纯骨性减压.Objective To investigate effects of three operation methods in treatment of Chiari Ⅰ with syringomyelia.Methods Retrospective study of patients betwenJune 2005 and June 2012 in The department of Neurosurgery,People＆#39;s Hospital of Xinjiang Uygur Autonomous Region for a total of 133 cases patient of Chiari Ⅰ malformation with syrigomyelia.Group A was performed in 20 cases for simple posterior bony decompression; group B was performed in 65 cases for posterior bony decompression ＋ dural enlargement repair;group C was performed in 48 cases for posterior bony decompression ＋ dural enlargement repair ＋ resection of the cerebellar tonsils.To comparison the effect of the operation,syringomyelia resolution and the rate of postoperative complications.Results Outpatient follow up for 6 months-9 years,a total of 118 patients were followed up for.According to the criteria of Tator,A,B,C three groups in the superior,good,poor rate was significant difference （P 〈 0.05）.Promote syringomyelia regression had significant difference（P 〈0.05）.Group B and C have the same effect of operation,better than group A.A,B,C three groups of infection were 1 case,2 cases,1 case; postoperative transient headache were 6 cases,30 cases,25 cases;early postoperative cerebrospinal fliud leakage and subcutaneous effusion were 0 case,8 cases,6 cases ; 1 case of death in group C.The total complication rate had no significant difference （P 〉 0.05）.Conclusion Posterior bony decompression plus dural enlargement repair,posterior bony decompression withdural enlargement repair andResection of the cerebellar tonsils were the same effect,arereliable methods for Chiari Ⅰ with syringomyelia,better than soly posterior bony decompression.

关 键 词：畸形并脊髓空洞 手术术式 手术并发症 

分 类 号：R651[医药卫生—外科学]