CAJ | 학술논문

目的观察枕后减压硬膜扩大修补+小脑扁桃体切除与枕后减压硬膜扩大修补两种手术方法治疗ChiariⅠ畸形的疗效.方法回顾性总结2006年1月-2012年6月新疆维吾尔自治区人民医院神经外科总共97例ChiariⅠ型畸形患者,A组行枕后减压硬膜扩大修补+小脑扁桃体切除55例;B组行枕后减压硬膜扩大修补42例,对比两组手术效果、空洞消退情况及术后近期并发症发病率.结果门诊随访6个月～8年,共随访到85例患者,按Tator疗效标准,A、B组优、良、差率比较差异无统计学意义(P＞0.05),促进空洞消退对比差异无统计学意义(P＞0.05).A、B两组术后分别有5例、4例患者发生切口感染,术后一过性头痛分别为25例、18例,术后早期脑脊液漏并皮下积液分别为8例、6例,A组死亡1例,总并发症发病率差异无统计学意义(P＞0.05).结论枕后减压硬膜扩大修补和枕后减压硬膜扩大修补+小脑扁桃体切除均是治疗Chiari Ⅰ畸形的可靠方法,两者手术效果无明显差异,而枕后减压硬膜扩大修补手术步骤较少,损伤更小.
목적 관찰침후감압경막확대수보+소뇌편도체절제여침후감압경막확대수보량충수술방법치료ChiariⅠ기형적료효.방법 회고성총결2006년1월-2012년6월신강유오이자치구인민의원신경외과총공97례ChiariⅠ형기형환자,A조행침후감압경막확대수보+소뇌편도체절제55례;B조행침후감압경막확대수보42례,대비량조수술효과、공동소퇴정황급술후근기병발증발병솔.결과 문진수방6개월～8년,공수방도85례환자,안Tator료효표준,A、B조우、량、차솔비교차이무통계학의의(P＞0.05),촉진공동소퇴대비차이무통계학의의(P＞0.05).A、B량조술후분별유5례、4례환자발생절구감염,술후일과성두통분별위25례、18례,술후조기뇌척액루병피하적액분별위8례、6례,A조사망1례,총병발증발병솔차이무통계학의의(P＞0.05).결론 침후감압경막확대수보화침후감압경막확대수보+소뇌편도체절제균시치료Chiari Ⅰ기형적가고방법,량자수술효과무명현차이,이침후감압경막확대수보수술보취교소,손상경소.
Objective Observation of Posterior decompression dural enlargement repair + Resection of the cerebellar tonsils and Posterior decompression dural enlargement repair two operation method for treatment of Chiari Ⅰ malformation effect.Methods Retrospectively analyze the clinical data from Jan.2006 to Jun.2012,the department of Neurosurgery,People's Hospital of Xinjiang Uygur Autonomous Region for a total of 97 cases of Chiari Ⅰ malformation.Group A was performed in 55 cases for Posterior decompression dural enlargement repair + Resection of the cerebellar tonsils,group B was performed in 42 cases for Posterior decompression dural enlargement repair,and was compared of the effect of the operation,Syringomyelia resolution and the rate of postoperative complications.Results Outpatient follow up for 6 months-8 years,a total of 85 patients were followed up for.According to the criteria of Tator,A,B two groups in the superior,good,poor rate was no significant difference (P ＞ 0.05).Promote syringomyelia regression had no significant difference(P ＞ 0.05).A,B two groups of postoperative incision infection were 5 cases and 4 cases,Postoperative transient headache were 25 cases,18 cases.Early postoperative cerebrospinal fliud leakage and subcutaneous effusion were 8 cases,6 cases.One cases died in group A.The total complication rate had no significant difference (P ＞ 0.05).Conclusions Posterior decompression dural enlargement repair + Resection of the cerebellar tonsils and Posterior decompression dural enlargement repair both are the treatment of Chiari Ⅰ malformation and reliable method.No significant difference exists between the effects of two operation,while the posterior decompression dural enlargement repair operation steps to reduce the damage.