[1]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):75-77.
　GAO Hong,YANG Hua,XIANG Xin..Curative effects of two surgical methods on Chiari Malformation type Ⅰ complicated with syringomyelia[J].,2018,(02):75-77.
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Chiari畸形Ⅰ型合并脊髓空洞症的显微手术治疗()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2018年02期
页码:
75-77
栏目:
论著
出版日期:
2018-03-05

文章信息/Info

Title:
Curative effects of two surgical methods on Chiari Malformation type Ⅰ complicated with syringomyelia
文章编号:
1009-153X（2018）02-0075-03
作者:
高　竑　杨　华　向　欣
作者单位：550000 贵阳，贵州医科大学临床医学院
Author(s):
GAO Hong;  YANG Hua;  XIANG Xin.
Clinical Medical School, Guizhou Medical University, Guiyang 550000, China
关键词:
Chiari畸形Ⅰ型; 脊髓空洞症; 单纯骨性减压术; 颅后窝成形术; 疗效
Keywords:
Chiari Ⅰ malformation;  Syringomyelia;  Posterior fossa decompression;  Posterior cranial fossa plastic repair
分类号:
R 742.8; R 651.1+1
文献标志码:
A
摘要:
目的 探讨Chiari畸形Ⅰ型合并脊髓空洞症的显微手术方法及其疗效。方法 回顾性分析2013年1月至2016年1月手术治疗的38例Chiari畸形Ⅰ型合并脊髓空洞症的临床资料，其中12例行单纯骨性减压术（对照组），26例行颅后窝成形术（骨性减压+硬膜扩大修补，观察组）。术后随访12个月。结果 对照组术后发生头痛5例、浅表感染1例；观察组术后发生头痛13例、脑脊液及皮下积液4例、浅表感染3例。对照组术后并发症总发生率（50.0%，6/12）明显低于观察组（76.9%，20/26；P<0.05）。对照组疗效优8例，良3例，差1例；观察组疗效优18例，良5例，差3例；两组术后疗效无统计学差异（P>0.05）。对照组随访11例，术后空洞闭合1例，缩小5例，无变化3例，增大2例；观察组随访20例，术后空洞闭合7例，缩小11例，无变化1例，增大1例；对照空洞改善率（54.5%，6/11）明显低于观察组（90.0%，18/20；P<0.05）。结论 颅后窝成形术比单纯骨性减压术并发症发生率更高，单纯骨性减压术和颅后窝成形术疗效相当，但是颅后窝成形术比单纯骨性减压术更有助于脊髓空洞的缩小、闭合。
Abstract:
Objective To evaluate the curative effects of posterior fossa decompression (PFD) and posterior cranial fossa plastic repair (PCFPR) on Chiari malformation typeⅠcomplicated with syringomyelia (CMTICS). Methods The clinical data of 38 patients with CMTICS, of whom, 12 underwent PFD and 26 PCFPR including decompression of posterior cranial fossa and dura plastic repair from January, 2013 to January, 2016, were analyzed retrospectively. Results Of 38 patients followed up for 12 months, 31 received MRI examination and 7 not during the following up. The rate (41.6%, 5/12) of postoperative complications occurrence was significantly lower in 12 patients undergoing PFD than that (76.9%, 20/26) in 26 patients undergoing PCFPR. There was insignificant difference in the prognoses evaluated by Tator scale between both the groups (P>0.05). The rate (90.0%, 18/20) of syringomyelia improvement was significant higher in 20 patients who were followed up with MRI after PCFPR than that (54.5%, 6/11) in the 11 patients who were followed up with MRI after PFD (P<0.05). Conclusions The incidence of postoperative complications induced by PCFPR is significantly higher than that induced by PFD, but its curative effect on the syringomyelia is significantly better than that of PFD in the patients with CMTICS. PCFPR is similar to PFD in the effects on CMTICS evaluated by Tator scale.

参考文献/References:

[1] Greenberg JK, Ladner TR, Olsen MA, et al. Validation of an international classification of diseases, ninth revision code algorithm for identifying Chiari malformation typeⅠsurgery in adults [J]. Neurosurgery, 2015, 77(2): 269-273.
[2] Arnautovic A, Splavski B, Boop FA, et al. Pediatric and adult Chiari malformation TypeⅠsurgical series 1965- 2013: a review of demographics, operative treatment, and outcomes [J]. J Neurosurg Pediatr, 2015, 15(2): 161-177.
[3] Zhao JL, Li MH, Wang CL, et al. A systematic review of ChiariⅠmalformation: techniques and outcomes [J]. World Neurosurg, 2016, 88: 7-14.
[4] Tator CH, Meguro K, Rowed DW. Favorable results with syringosubarachnoid shunts for treatment of syringomyelia [J]. J Neurosurg, 1982, 56(4): 517-523.
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备注/Memo

备注/Memo:
通讯作者：向　欣，E-mail：xiangxin828@163.com
更新日期/Last Update: 2018-03-05