颅底陷入症合并小脑扁桃体下疝畸形的手术治疗探讨  

Skull base entrapment with cerebellar subtonsillar hernia

作　　者：史飞 张剑宁 李兵 Shi Fei;Zhang Jianning;Li Bing(Department of Neurosurgery,Central Theater Air Force Hospital,Datong,Shanxi 037006,China;Department of Neurosurgery,PLA Navy General Hospital,Datong,Shanxi 037006,China;Department of Neurosurgery,the First Affiliated Hospital of Air Force Military Medical University,Datong,Shanxi 037006,China.)

机构地区：[1]中部战区空军医院神经外科,山西大同037006 [2]解放军海军总院神经外科,山西大同037006 [3]空军军医大学第一附属医院神经外科,山西大同037006

出　　处：《影像研究与医学应用》2020年第9期23-24,共2页Journal of Imaging Research and Medical Applications

摘　　要：目的:探讨颅底陷入症合并小脑扁桃体下疝畸形的手术治疗方法与效果。方法:选择50例颅底陷入症合并小脑扁桃体下疝畸形患者进行研究,均接受前后路联合手术方案治疗。术前与术后用CT与MRI检查,并且随访至少1年以上,了解术后症状缓解情况,以及随访期间生活自理、活动或劳动恢复情况,比较术前与术后延颈髓受压成角、小脑扁桃体下疝深度及Klaus高度指数。结果:经过前后路联合手术治疗后患者的症状均有好转,随访1年时所有患者均可生活自理;随访1年时,28例可简单体育活动,20例可轻微体力劳动,剩余2例无法完成体育活动与体力劳动;术后延颈髓受压成角更大,小脑扁桃体下疝深度更小,Klaus高度指数更大,与术前差异有统计学意义(P<0.05)。结论:颅底陷入症合并小脑扁桃体下疝畸形应用前后路联合手术方案治疗可取得不错的效果,患者术后症状好转,随访1年基本可生活自理,且大部分能恢复轻微体育活动或体力劳动,同时可明显改善CT与MRI结果。Objective To explore the surgical treatment and effect of cranial base entrapment combined with cerebellar subtonsillar hernia.Methods 50 patients with skull base entrapment combined with cerebellar subtonsillar hernia were selected for study.All patients received anterior and posterior combined surgery treatment.Preoperative and postoperative CT and MRI examinations,and follow-up for at least 1 year,to understand the postoperative symptom relief and self-care,activity or labor recovery during follow-up,compare the cervical spinal cord compression angle before and after surgery,Cerebellar hernia depth and Klaus height index.Results The symptoms of the patients improved after anterior-posterior combined surgery.All patients were able to take care of themselves at 1-year follow-up.At 1-year follow-up,28 patients could perform simple physical activities,20 patients could perform light physical labor,and the remaining 2 patients could not.Complete physical activity and physical labor;postoperative cervical spinal cord compression angle was greater,cerebellar subtonsillar hernia depth was smaller,Klaus height index was larger,and the difference was statistically significant (P<0.05).Conclusion Skull base entrapment combined with cerebellar inferior tonsillar hernia deformity can achieve good results with anterior-posterior combined surgical treatment.The patient’s symptoms improved after the operation,and after 1 year’s follow-up,he can basically take care of himself,and most of them can recover light physical activity or physical labor.At the same time,CT and MRI results can be significantly improved.

关 键 词：颅底陷入症 小脑扁桃体下疝畸形 前后路联合手术 CT MRI 

分 类 号：R651.11[医药卫生—外科学]