[1]刘　彬　王振宇　谢京诚　李振东　马长城　陈晓东.Chiari畸形合并脊髓空洞症术中不同大小后颅窝减压窗近期疗效的比较[J].中国临床神经外科杂志,2016,(01):10-12,16.[doi:10.13798/j.issn.1009-153X.2016.01.004]
　LIU Bin,WANG Zhen-yu,XIE Jing-chen,et al.Effect of decompression window area of posterior fossa on short-term surgical outcomes in Chiari malformation patients with syringomyelia[J].,2016,(01):10-12,16.[doi:10.13798/j.issn.1009-153X.2016.01.004]
点击复制

Chiari畸形合并脊髓空洞症术中不同大小后颅窝减压窗近期疗效的比较()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2016年01期
页码:
10-12,16
栏目:
论著
出版日期:
2016-01-25

文章信息/Info

Title:
Effect of decompression window area of posterior fossa on short-term surgical outcomes in Chiari malformation patients with syringomyelia
文章编号:
1009-153X（2016）01-0010-03
作者:
刘　彬　王振宇　谢京诚　李振东　马长城　陈晓东
100191 北京，北京大学第三医院神经外科（刘　彬、王振宇、谢京诚、李振东、马长城、陈晓东）
通讯作者：王振宇，E-mail：wzyu502@hotmail.com
Author(s):
LIU Bin;  WANG Zhen-yu;  XIE Jing-chen;  LI Zhen-dong;  MA Chang-chen;  CHEN Xiao-dong.
Department of Neurosurgery, The Third Hospital, Peking University, Beijing 100191, China
关键词:
Chiari畸形; 脊髓空洞症; 手术; 疗效
Keywords:
Chiari malformation ;  Syringomyelia;  Surgery;  Decompression area;  Therapeutic effect
分类号:
R 742.8+2; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2016.01.004
文献标志码:
A
摘要:
目的 探讨不同大小后颅窝骨性减压窗对Chiari畸形合并脊髓空洞症患者手术近期疗效的影响。方法 回顾性分析2007~2010年收治的117例Chiari畸形合并脊髓空洞症患者的临床资料，均采用环枕减压硬膜成形术，空洞横径>脊髓50%者行空洞穿刺减压术。根据后颅窝减压窗面积分为2组：Ⅰ组，87例，减压面积为12 cm2（3 cm×4 cm）；Ⅱ组，30例，减压面积<6 cm2。术后2周采用Tater评分评定疗效。结果 117例患者手术后症状均无加重，症状改善97例（82.9%），无变化20例。Ⅰ组症状改善76例（87.4%），Ⅱ组为21例（70%）；两组症状改善率差异显著（P<0.05）。>结论 Chiari畸形合并脊髓空洞症患者的后颅窝减压面积以不小于12 cm2的近期疗效较好。
Abstract:
Objective To explore the effect of decompression skull window area on short-term surgical outcomes in the Chiari malformation (CM) patients with syringomyelia (SM). Methods The clinical data of 117 patients with CM and SM treated in our hospital from 2007 to 2010 were analyzed retrospectively. The decompression of posterior cranial fossa and duraplasty was performed in all the patients. The decompression of syringomyelias with puncture was performed in the patients in whom the horizontal diameters of the syringomyelias were more than 50% of the horizontal diameters of the spinal cords. The patients were divided into 2 groups according to the decompressed area of the posterior cranial fossa, i.e. group A (n=87) where the decompression skull window area was about 12 cm2 and group B (n=30) where the skull window area was less than 6 cm2. The therapeutic effects were evaluated with Tater scale 2 weeks after the operation in all the patients. Results Of 117 patients, 97 were improved in the postoperative symptoms and 20 not. The rate (87.4%, 76/87) of improved symptoms was significantly higher in group A than that (70.0%, 21/30) in group B (P

参考文献/References:

[1] Haroun RI, Guarnieri M, Meadow JJ, et al. Current opinions for the treatment of syringomyelia and chiari malformations: survey of the Pediatric Section of the American Association of Neurological Surgeons [J]. Pediatr Neurosurg, 2000, 33 (6): 311-317.
[2] Rocque BG, George TM, Kestle J, et al. Treatment practices for Chiari malformation type I with syringomyelia: results of a survey of the American Society of Pediatric Neurosurgeons [J]. J Neurosurg Pediatr, 2011, 8(5): 430-437.
[3] 刘　彬，王振宇，李振东，等. 不同手术方式治疗ChiariⅠ 畸形合并脊髓空洞的临床研究[J]. 中华神经医学杂志， 2005，4（11）：1137-1139.
[4] 刘　彬，王振宇，江　凌，等. 彩色多谱勒超声评价Chiari Ⅰ畸形环枕减压硬膜成形前后脑脊液动力学变化[J]. 中 华神经医学杂志，2011，10（3）：272-275.
[5] Durham SR, Fjeld-Olenec K. Comparison of posterior fossa decompression with and without duraplasty for the surgical treatment of Chiari malformation TypeⅠin pediatric pa- tients: a meta-analysis [J]. J Neurosurg Pediatr, 2008, 2 (1): 42-49.
[6] Iwasaki Y, Hida K, Koyanagi I, et al. Reevaluation of syrin- gosubarachnoid shunt for syringomyelia with Chiari mal- formation [J]. Neurosurgery, 2000, 46(2): 407-413.
[7] Motta L, Skerritt GC. Syringosubarachnoid shunt as a mana- gement for syringohydromyelia in dogs [J]. J Small Anim Pract, 2012, 53(4): 205-212.
[8] 马长城，王振宇，袁慧书. Chiari畸形后颅窝的形态学研 究及手术选择[J]. 北京大学学报（医学版），2008，40（2）： 211-213.
[9] Milhorat TH, Bolognese PA. Tailored operative technique for Chiari type I malformation using intraoperative color Doppler ultrasonography [J]. Neurosurgery, 2003, 53(4): 899-906.
[10] Spena G, Bernucci C, Garbossa D, et al. Clinical and radio- logical outcome of craniocervical osteo-dural decompre- ssion for Chiari I-associated syringomyelia [J]. Neurosurg Rev, 2010, 33(3): 297-304.
[11] Holly LT, Batzdorf U. Management of cerebellar ptosis following craniovertebral decompression for ChiariⅠmal- formation [J]. J Neurosurg, 2001, 94(1): 21-26.
[12] 李永宁，王任直，邸　虓. 神经内镜下Chairi畸形寰枕减 压手术[J]. 中国医学科学院学报，2007，29（1）：134-136.
[13] Sgouros S, Kountouri M, Natarajan K. Posterior fossa volume in children with Chiari malformation TypeⅠ[J]. J Neuro- surg, 2006, 105(2 Suppl): 101-106.
[14] Lazareff JA, Galarza M, Gravori T, et al. Tonsillectomy with- out craniectomy for the management of infantile Chiari Ⅰ malformation [J]. J Neurosurg, 2002, 97(5): 1018-1022.
[15] Lee HS, Lee SH, Kim ES, et al. Surgical results of arach- noid-preserving posterior fossa decompression for ChiariⅠ malformation with associated syringomyelia [J]. J Clin Neurosci, 2012, 19(4): 557-560.

相似文献/References:

[1]黄忻涛 综述,王振宇 审校.Chiari畸形外科治疗进展[J].中国临床神经外科杂志,2017,(02):112.[doi:10.13798/j.issn.1009-153X.2017.02.019]
[2]邱军,范涛,赵新岗,等.Chiari畸形合并颅底凹陷症1例[J].中国临床神经外科杂志,2017,(02):121.[doi:10.13798/j.issn.1009-153X.2017.02.023]
[3]高　竑　杨　华　向　欣.Chiari畸形Ⅰ型合并脊髓空洞症的显微手术治疗[J].中国临床神经外科杂志,2018,(02):75.
　GAO Hong,YANG Hua,XIANG Xin..Curative effects of two surgical methods on Chiari Malformation type Ⅰ complicated with syringomyelia[J].,2018,(01):75.
[4]康宏达　卢二勤　宋　凯　李　杰.Chiari畸形术后寰枕交界区稳定性的临床观察[J].中国临床神经外科杂志,2018,(03):204.[doi:10.13798/j.issn.1009-153X.2018.03.023]
[5]强京灵　田德洲　张远征.Chiari畸形Ⅰ型合并睡眠呼吸暂停综合征的手术治疗分析[J].中国临床神经外科杂志,2018,(08):529.[doi:doi:10.13798/j.issn.1009-153X.2018.08.006]
　QIANG Jing-ling,TIAN De-zhou,ZHANG Yuan-zheng..Microsurgery for Chiari malformation type Ⅰassociated with central sleep apnea hypopnea sydrome (report of 6 cases)[J].,2018,(01):529.[doi:doi:10.13798/j.issn.1009-153X.2018.08.006]
[6]刘晓虎,罗霜,付兵,等.PC-MRI在Ⅰ型Chiari畸形枕大池成形术后疗效评估中的应用[J].中国临床神经外科杂志,2022,27(01):22.[doi:10.13798/j.issn.1009-153X.2022.01.008]
　LIU Xiao-hu,LUO Shuang,FU Bing,et al.Clinical application of phase-contrast magnetic resonance image in postoperative evaluation of Chiari malformation type Ⅰ[J].,2022,27(01):22.[doi:10.13798/j.issn.1009-153X.2022.01.008]
[7]修波,李萃萃,林和璞,等.Chiari畸形113例手术治疗分析[J].中国临床神经外科杂志,2017,(07):460.[doi:10.13798/j.issn.1009-153X.2017.07.005]
　XIU Bo,LI Cui-cui,LIN He-pu,et al.Microsurgery for Chiari malformations (report of 113 cases)[J].,2017,(01):460.[doi:10.13798/j.issn.1009-153X.2017.07.005]
[8]何运森　郑　涛　张孙鑫　李肖越 综述　吴　波 审校.Chiari畸形Ⅰ型合并脊髓空洞症的诊疗进展[J].中国临床神经外科杂志,2019,(01):55.[doi:10.13798/j.issn.1009-153X.2019.01.018]

更新日期/Last Update: 2016-01-30