CAJ | 학술논문

目的比较Chiari畸形合并脊髓空洞症在应用单纯枕骨大孔减压术及枕骨大孔减压术+脊髓空洞-蛛网膜下隙分流术两种手术方式的临床治疗效果.方法选取49例Chiari畸形合并脊髓空洞症患者,28例行单纯枕骨大孔减压术(术式一组),21例行枕骨大孔减压术+脊髓空洞-蛛网膜下隙分流术(术式二组).根据术后临床疗效及复查MRI后判定两种手术方式治疗效果.结果术式一组18例有效,10例无效,有效率64.3％(18/28),术式二组19例有效,2例无效,有效率90.5％(19/21),两组有效率比较差异有统计学意义(x2=4.45,P=0.034).结论枕骨大孔减压术+脊髓空洞-蛛网膜下隙分流术是治疗Chiari畸形合并脊髓空洞症有效手段,手术疗效较单纯枕骨大孔减压术确切,适用于Chiari畸形合并脊髓空洞症患者,其治疗机制符合最新脊髓空洞症发病机制.
목적 비교Chiari기형합병척수공동증재응용단순침골대공감압술급침골대공감압술+척수공동-주망막하극분류술량충수술방식적림상치료효과.방법 선취49례Chiari기형합병척수공동증환자,28례행단순침골대공감압술(술식일조),21례행침골대공감압술+척수공동-주망막하극분류술(술식이조).근거술후림상료효급복사MRI후판정량충수술방식치료효과.결과 술식일조18례유효,10례무효,유효솔64.3％(18/28),술식이조19례유효,2례무효,유효솔90.5％(19/21),량조유효솔비교차이유통계학의의(x2=4.45,P=0.034).결론 침골대공감압술+척수공동-주망막하극분류술시치료Chiari기형합병척수공동증유효수단,수술료효교단순침골대공감압술학절,괄용우Chiari기형합병척수공동증환자,기치료궤제부합최신척수공동증발병궤제.
Objective To investigate the efficacy of foramen magnum decompression alone and foramen magnum decompression + Syrinx-shunt in the treatment of Chiari anomalies with syringomyelia.Methods Forty-nine Chiari anomalies with syringomyelia patients were selected,28 patients performed foramen magnum decompression alone (surgical method Ⅰ group),21 patients performed foramen magnum decompression + Syrinx-shunt (surgical method Ⅱ group).The treatment efficacy was evaluated by postoperative clinical effect and MRI review.Results In surgical method Ⅰ group,effective in 18 cases,invalid in 10 cases,the effective rate was 64.3％ (18/28).In surgical method Ⅱ group,effective in 19 cases,invalid in 2 cases,the effective rate was 90.5％(19/21).There was statistical difference (x2 =4.45,P =0.034).Conclusion Foramen magnum decompression + Syrinx-shunt is effective in the treatment of Chiari anomalies with syringomyelia,which is applicable for these patients and has a more precise consequence than foramen magnum decompression alone.