显微填塞治疗症状性骶管囊肿的长期疗效  

Long-term outcome of microsurgical stuffing in the treatment of symptomatic sacral Tarlov cysts

作　　者：文泽贤 储卫华[1] 叶信珍[1] 薛兴森[1] 袁继超[2] 刘伟[1] 陈亚星[1] 陈飞[1] 冯华[1] 林江凯[1] 

机构地区：[1]第三军医大学西南医院神经外科,重庆400038 [2]第三军医大学西南医院神经内科,重庆400038

出　　处：《中国微侵袭神经外科杂志》2017年第4期172-175,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：第三军医大学西南医院"军事医学与战创伤救治临床新技术计划"(编号:SWH2016BZGFGJJ-06)

摘　　要：目的评估纤维蛋白胶辅以自体脂肪、明胶海绵填塞治疗症状性骶管囊肿的疗效。方法回顾性分析72例症状性骶管囊肿病人的临床资料,均行显微手术填塞治疗。采用数字模拟评分方法 (numerical rating scale,NRS)评估病人治疗前后的疼痛程度,同时观察神经功能障碍改善情况,并分析其疗效。结果术后症状均消失或明显改善,无加重或继发神经功能障碍。术前、术后2周、1年、3~6年中位NRS分别为6(5,7)、1(0,2)、1(0,2)、1(0,3)分;术后NRS均较术前明显降低(均P<0.05),术后3~6年NRS较术后2周、术后1年加重(均P<0.05)。术后2周、1年、3~6年有效率分别为97.2%、90.3%、76.6%。术后2周、1年的有效率高于术后3~6年(均P<0.05)。结论显微填塞治疗症状性骶管囊肿病人,能明显改善其疼痛及神经功能障碍且有效率高。Objective To estimate the treatment efficiency of microsurgical treatment of symptomatic sacral Tarlov cysts by stuffing with fibrin glue, autologous fat and gelatin sponge. Methods Clinical data of 72 patients with symptomatic sacral Taflov cysts were analyzed retrospectively, who received microsurgical treatment by stuffing with fibrin glue, autologous fat and gelatin sponge. Numerical rating scale （NRS） was used to assess pain intensity before and after surgery. The improvement of neurological deficits was also observed, and the therapeutic outcome was analyzed. Results The symptoms disappeared or were improved obviously, and there were no aggravations or secondary neurological deficits. The median NRS was 6（5, 7）, 1 （0, 2）, 1 （0, 2）, 1 （0, 3） respectively before surgery and 2 weeks, 1 year, 3 to 6 years after surgery. Compared with preoperative NRS, the postoperative NRS was significantly lower （all P〈 0.05）. The NRS of 3 to 6 years after surgery was higher than that of 2 weeks and 1 year after surgery （both P〈 0.05）. The response rates were 97.2%, 90.3%, 76.6% respectively 2 weeks, 1 year, 3 to 6 years after surgery. The response rates of 2 weeks and 1 year after surgery were higher than those of 3 to 6 years after surgery （both P 〈 0.05）. Conclusion Microsurgical stuffing can significantly relieve pain and improve the neurologic deficits of patients with symptomatic sacral Tarlov cysts and obtain a high response rate.

关 键 词：Tarlov囊肿 骶管 显微外科手术 填塞 疼痛 

分 类 号：R651[医药卫生—外科学]