Chiari畸形Ⅰ型患者术后常规腰大池置管引流术的临床疗效  

Necessity of routine lumbar continuous drainage of fluid on treatment postoperative of Chiari malformation typeⅠ

作　　者：樊宇耕 袁胤淞 赵开胜[2] 杨小岗[2] 强京灵 FAN Yugeng;YUAN Yinsong;ZHAO Kaisheng;YANG Xiaogang;QIANG Jingling(Department of Neurosurgery,Yan′an People′s Hospital,Yan′an 716000,China;Department of Neurosurgery,Yan′an University Affiliated Hospital,Yan′an 716000,China)

机构地区：[1]延安市人民医院神经外科,陕西延安716000 [2]延安大学附属医院神经外科,陕西延安716000

出　　处：《延安大学学报(医学科学版)》2025年第1期32-36,共5页Journal of Yan'an University:Medical Science Edition

摘　　要：目的观察常规行腰大池置管引流术(lumbar continuous drainage of fluid,LCDF)对Chiari畸形Ⅰ型患者术后早期并发症的临床疗效。方法回顾性分析2019年07月至2022年12月收治的Chiari畸形Ⅰ型68例患者的临床资料,均在全麻下行后正中入路软膜下下疝小脑扁桃体切除及枕大池重建术。按照术后第1天是否行LCDF分为两组,观察组36例行LCDF,对照组32例未行LCDF,比较分析两组患者术后临床症状恢复时间、术后并发症及术后住院时间,术后随访12个月,观察两组的远期疗效情况。结果两组术后随访无死亡病例,对照组总并发症发生率为71.88%,观察组总并发症发生率为25.0%,观察组并发症发生率低于对照组;对照组平均术后住院时间(14.8±1.8)d,观察组平均术后住院时间(10.4±1.5)d,观察组术后住院时长较对照组更短,两组之间差异具有统计学上的显著性意义。两组术后临床症状恢复时间、术后远期疗效情况比较差异无统计学意义(P>0.05)。结论Chiari畸形I型患者实施后正中入路小脑扁桃体软膜下下疝切除联合枕大池重建术后常规行LCDF可明显降低术后并发症,缩短术后住院时间,减少住院费用,符合术后加速康复理念。Objective To observe the clinical effect of routine lumbar continuous drainage of fluid(LCDF)on early postoperative complications of Chiari malformation typeⅠ.Methods The clinical data of 68 patients with Chiari malformationⅠwho were admitted from July 2019 to December 2022 were prospectively analyzed.All patients underwent subpalysmal herniation and cerebelar tonsillectomy and cistern majoroccipital reconstruction through posterior median approach under general anesthesia.The patients were divided into 2 groups according to whether they received LCDF on the first day after surgery.36 patients in the observation group received LCDF,and 32 patients in the control group did not receive LCDF.The postoperative recovery time of clinical symptoms,postoperative complications and postoperative hospitalization time of the patients in the 2 groups were compared and analyzed.Results There were no deaths in the two groups during postoperative follow-up.The overall complication rate in the control group was 71.88%,while in the observation group,it was 25.0%.The observation group showed a markedly lower complication rate than the control group.The average length of postoperative hospital stay for the control group was 14.8±1.8 days,compared to 10.4±1.5 days in the observation group.The observation group had a significantly shorter average hospital stay than the control group(P<0.05).There was no significant difference between the two groups regarding the recovery time of clinical symptoms or long-term efficacy(P>0.05).Conclusion Routine lumbar drainage following the removal of herniated cerebellar tonsils and the reconstruction of the cisterna magna through a posterior midline approach in patients with Chiari malformation type I significantly reduces postoperative complications,shortens the length of hospital stay,and lowers hospitalization costs.This aligns with the principles of enhanced recovery after surgery.

关 键 词：Chiari畸形Ⅰ型 小脑扁桃体切除 腰大池引流 枕大池重建。 

分 类 号：R651[医药卫生—外科学]