小脑扁桃体下疝畸形的临床诊断及治疗  

The diagnosis and treatment of chiari malformation

作　　者：乌拉别克.毛力提 艾克拜尔.亚里坤 Wulabieke Maoliti Aikebaier Yalikun(Department of Neurosurgery , the People＇s Hospital of Xinjiang Uygur Autonomous Region ,Urumqi 830001 ,China)

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

出　　处：《中国实用神经疾病杂志》2016年第18期14-15,共2页Chinese Journal of Practical Nervous Diseases

摘　　要：目的研究小脑扁桃体下疝畸形的临床诊断及治疗方法,以期为临床诊治提供一定的依据。方法选取2012-01—2014-01收治的符合小脑扁桃体下疝畸形诊断标准的患者41例,所有患者均行后颅窝减压术及部分扁桃体切除术。术后1个月复查,根据格拉斯哥预后评分评价治疗效果。术后随访6～12个月,观察患者的症状改善及并发症情况。结果 41例患者中术后1个月复查,恢复良好33例（75.61%）,疗效较差10例（24.39%）。39例生存患者中,症状改善优22例,良13例,总有效率为89.74%。术后发热（38～39℃）10例,发热时间〈1周。随访期间患者并未发生脑脊液漏、颅内感染、脑脊髓蛛网膜炎等重症并发症。结论小脑扁桃体下疝畸形患者在诊断中应结合临床症状与影像学辅助。应用后颅窝减压术及部分扁桃体切除术,同时结合人工补片扩大修补硬膜,患者预后较好,可有效改善临床症状,同时减轻术后并发症。Objective To study the diagnosis and treatment of chiari malformation so as to provide references for clinical practices.Methods Forty-one patients meeting diagnostic criteria of chiari malformation who received posterior fossa decom-pression and partial tonsillectomy from January 2012 to January 2014 were selected.The prognosis was evaluated by using Glasgow scale in one month after operation and the improvement of symptoms and complications were observed in the 6-12 months follow-up period.Results One month after operation for all 41 cases,there were 33 cases with good recovery （75.61%）,10 cases with weak efficacy（24.39%）.Of the 39 survivals,symptoms improved well occurred in 22 cases,good in 13 cases,with the total effective rate of 89.74%.Postoperative fever ranging from 38 ℃ to 39 ℃ happened to 10 cases,with fe-ver time less than one week.During the follow-up,there was no one presenting cerebrospinal fluid leakage,intracranial infec-tion,cerebral spinal-arachnoiditis and other severe complications.Conclusion We should combine clinical symptoms with ima-ging exanimation to diagnosis chiari malformation.The Application of posterior fossa decompression and partial tonsillectomy as well as expanding repair of dura mater with artificial mesh may play clinical roles in improving the clinical symptoms,reduc-ing postoperative complications and improving progress.

关 键 词：小脑扁桃体下疝畸形 诊断 手术 

分 类 号：R651.15[医药卫生—外科学]