不同术式治疗Chiari Ⅰ型畸形的疗效观察  

Effect comparision of two different surgery approaches in the treatment of Chiari Ⅰ malformation

作　　者：吴晓东[1] 张勇 王斌[1] 

机构地区：[1]安徽省淮北市人民医院脑外科,235000

出　　处：《蚌埠医学院学报》2017年第2期215-217,共3页Journal of Bengbu Medical College

摘　　要：目的:探讨2种不同手术方式治疗ChiariⅠ型畸形的疗效及并发症发生情况。方法:选择ChiariⅠ型畸形患者42例,根据手术方式分为A组(后颅窝单纯骨性减压术)19例和B组(后颅窝骨性减压+扩大硬膜修补+下疝扁桃体切除术)23例。结果:A组患者治疗有效11例,无效8例,有效率57.89%;B组患者治疗有效21例,无效2例,有效率91.30%,B组疗效优于A组(P<0.05)。A组术后发生并发症2例(10.53%),B组10例(43.48%),B组患者术后并发症总发生率高于A组(P<0.05)。结论:后颅窝骨性减压+扩大硬膜修补+下疝扁桃体切除术治疗ChiariⅠ型畸形疗效较好,但术后并发症发生率较高。Objective：To investigate the clinical effects and incidence of complications of two different surgery approaches in the treatment of Chiari I malformation. Methods：Forty-two patients with Chiari I malformation were divided into the group A （ 19 cases） and group B （ 23 cases ） according to the surgery approach. The groups A and B were treated with posterior cranial fossa bony decompression and posterior cranial fossa bony decompression, expanding the dural repair combined with cerebellar tonsillar resection, respectively. Results ： The valid treatment in 11 cases and invalid treatment in 8 cases were found in group A, the effective rate of which was 57.89% ,and the valid treatment in 21 cases and invalid treatment in 2 cases were found in group B ,the effective rate of which was 57.89%. The treatment effect in group B was better than that in group A（P 〈0.05）. The postoperative complications were found in 2 eases of group A（ 10.53% ） and 10 cases of group B（43.48% ） ,and the total incidence rate of the postoperative complication in group B was higher than that in group A（P 〈 0.05 ）. Conclusions ：The treatment effect of Chiari I malformation with posterior cranial fossa bony decompression, expanding the dural repair combined with cerebellar tonsillar resection is good, but incidence rate of the postoperative complication of which is high.

关 键 词：ChiariⅠ型畸形 后颅窝骨性减压 扩大硬膜修补 下疝扁桃体切除术 

分 类 号：R742.82[医药卫生—神经病学与精神病学] R651.1[医药卫生—临床医学]