Chiari畸形合并脊髓空洞症两种术式治疗比较  

Comparison of efficacy of two surgical methods for Chiari anomalies with syringomyelia

作　　者：周建波[1] 刁宏宇[1] 李博洋[1] 刘斯琪[1] 李新星[1] 

机构地区：[1]中国医科大学附属盛京医院神经外科,沈阳110004

出　　处：《中国医师进修杂志》2014年第35期34-37,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 比较Chiari畸形合并脊髓空洞症在应用单纯枕骨大孔减压术及枕骨大孔减压术＋脊髓空洞-蛛网膜下隙分流术两种手术方式的临床治疗效果.方法 选取49例Chiari畸形合并脊髓空洞症患者,28例行单纯枕骨大孔减压术（术式一组）,21例行枕骨大孔减压术＋脊髓空洞-蛛网膜下隙分流术（术式二组）.根据术后临床疗效及复查MRI后判定两种手术方式治疗效果.结果 术式一组18例有效,10例无效,有效率64.3％（18/28）,术式二组19例有效,2例无效,有效率90.5％（19/21）,两组有效率比较差异有统计学意义（x2=4.45,P=0.034）.结论 枕骨大孔减压术＋脊髓空洞-蛛网膜下隙分流术是治疗Chiari畸形合并脊髓空洞症有效手段,手术疗效较单纯枕骨大孔减压术确切,适用于Chiari畸形合并脊髓空洞症患者,其治疗机制符合最新脊髓空洞症发病机制.Objective To investigate the efficacy of foramen magnum decompression alone and foramen magnum decompression ＋ Syrinx-shunt in the treatment of Chiari anomalies with syringomyelia.Methods Forty-nine Chiari anomalies with syringomyelia patients were selected,28 patients performed foramen magnum decompression alone （surgical method Ⅰ group）,21 patients performed foramen magnum decompression ＋ Syrinx-shunt （surgical method Ⅱ group）.The treatment efficacy was evaluated by postoperative clinical effect and MRI review.Results In surgical method Ⅰ group,effective in 18 cases,invalid in 10 cases,the effective rate was 64.3% （18/28）.In surgical method Ⅱ group,effective in 19 cases,invalid in 2 cases,the effective rate was 90.5%（19/21）.There was statistical difference （x2 =4.45,P =0.034）.Conclusion Foramen magnum decompression ＋ Syrinx-shunt is effective in the treatment of Chiari anomalies with syringomyelia,which is applicable for these patients and has a more precise consequence than foramen magnum decompression alone.

关 键 词：脊髓空洞症 CHIARI畸形 枕骨大孔减压 

分 类 号：R744.4[医药卫生—神经病学与精神病学]