硬膜内、外腔联合松解术治疗脊髓栓系综合征的疗效  

Efficacy of intradural-and epidural-lysis for patients with tethered cord syndrome

作　　者：李伟[1] 罗意革[1] 陈嘉波[1] 苏成[1] 李彦强[1] 王从军[1] 史波[1] 李勇[1] LI Wei;LUO Yi-ge;CHEN Jia-bo;SU Cheng;LI Yan-qiang;WANG Cong-jun;SHI Ho;LI Yong(Pediatric Surgery Department,The First Affliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院小儿外科,南宁530021

出　　处：《中国临床神经外科杂志》2020年第8期497-499,共3页Chinese Journal of Clinical Neurosurgery

基　　金：广西医疗卫生适宜技术开放与推广应用项目(S2018051);广西壮族自治区卫健委计划课题(Z20190464)。

摘　　要：目的探讨硬膜内、外腔联合松解术治疗脊髓栓系综合征的临床疗效。方法回顾性分析1998年1月至2016年6月手术治疗的286例脊髓栓系综合征患儿的临床资料,采用常规手术治疗77例(常规组),采用硬膜内、外腔联合松解术治疗209例(联合松解组)。结果常规组术后并发症发生率(10.4%,8/77)与联合松解组(6.2%,13/209)无统计学差异(P>0.05)。常规组术后6个月Hoffman分级较术前无明显差异(P>0.05)。联合松解组术后6个月Hoffman分级较术前明显改善(P<0.05),而且明显优于常规组(P<0.05)。术后6个月,常规组显效7例,改善6例,稳定43例,加重21例;联合松解组显效30例,改善32例,稳定132例,加重15例;联合松解组疗效明显优于常规组(P<0.05)。结论对于脊髓栓系综合征,在硬膜内腔脊髓栓系松解的基础上,探查硬膜外腔,松解硬膜外腔粘连栓系、离断外终丝,可进一步提高手术效果。Objective To explore the clinical efficacy of intradural-and epidural-lysis for the patients with tethered cord syndrome(TCS).Methods The clinical data of 286 children with TCS who were surgically treated from January 1998 to June 2016 were retrospectively analyzed.Of these 286 children,77 patients were treated with conventional surgery(control group),and 209 patients were treated with intradural-and epidural-lysis(observation group).Results The Hoffman classification of the patients in control group did not significantly changed 6 months after the surgery than before the surgery(P>0.05).The Hoffman classification of the patients in observation group was significantly improved 6 months after the operation than before the operation(P<0.05).The Hoffman classification of the patients in observation group was significantly better than that in control group 6 months after the operation(P<0.05).The curative effectness of the patients in observation group was significantly better than that in control group 6 months after the operation(P<0.05).Conclusion For children with TCS,based on the release of the spinal cord in the intradural space,surgical exploration of the epidural space,release of the adhesion tether in epidural space,and disconnection of the outer terminal wire can further improve the surgical effect.

关 键 词：脊髓栓系综合征 硬膜内、外腔联合松解术 疗效 

分 类 号：R744.9[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]