摘要
目的探讨神经内镜下改良后颅窝减压术治疗Chiari畸形Ⅰ型的临床疗效。方法回顾性分析2015年1月至2019年12月西安交通大学第一附属医院神经外科收治的63例Chiari畸形Ⅰ型患者的临床资料。其中,28例行神经内镜下改良后颅窝减压术(观察组),35例行后颅窝减压硬膜成形术(对照组)。对比两组术后Tator分级、脊髓空洞改善及并发症的发生,评估术后疗效。结果63例患者手术顺利,无死亡等严重并发症。其中,观察组术后有效率为78.6%,对照组为54.3%,差异有统计学意义(P<0.05);观察组术后脊髓空洞改善程度明显优于对照组(P<0.05);观察组术后并发症的发生与对照组相比差异无统计学意义(P>0.05)。结论神经内镜下改良后颅窝减压术治疗Chiari畸形Ⅰ型安全、有效,术中硬膜水密缝合加硬膜肌肉悬吊有利于减少术后皮下积液的发生。
Objective To investigate the clinical efficacy of modified posterior fossa decompression in treating Chiari type I malformation under the neuroendoscope.Methods We made a retrospective analysis of the clinical data of 63 patients with Chiari type I malformation treated at the Neurosurgery Department of The First Affiliated Hospital of Xi’an Jiaotong University from January 2015 to December 2019.Of the patients,28 ones underwent modified posterior fossa decompression assisted with neuroendoscopy(observation group)while 35 received posterior fossa decompression with duraplasty(control group).Tator grading,syringomyelia improvement and complications were compared between the two groups to evaluate the postoperative efficacy.Results The operations were successful in all the 63 patients and no death or severe neurological dysfunction was observed.The efficacy rate was 78.6%in the observation group and 54.3%in the control group,with significant difference(P<0.05).Furthermore,the postoperative improvement of syringomyelia was significantly better in the observation group than in the control group(P<0.05).However,there was no significant difference in postoperative complications between the two groups(P>0.05).Conclusion Modified posterior fossa decompression assisted with neuroendoscope is a safe and effective treatment for Chiari typeⅠmalformation.Intraoperative dural watertight suture and dural-muscle suspension can help reduce the occurrence of subcutaneous effusion.
作者
冒平
王乙锠
李奇
宋千
王宁
廉民学
鲍刚
何百祥
MAO Ping;WANG Yichang;LI Qi;SONG Qian;WANG Ning;LIAN Minxue;BAO Gang;HE Baixiang(Department of Neurosurgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China)
出处
《西安交通大学学报（医学版）》
CAS
CSCD
北大核心
2021年第4期608-611,共4页
Journal of Xi’an Jiaotong University（Medical Sciences）
基金
西安交通大学第一附属医院临床研究资助项目(No.XJTU1AF-CRF-2015-020)。
关键词
Chiari畸形Ⅰ型
后颅窝减压
神经内镜
Chiari typeⅠmalformation
posterior fossa decompression
neuroendoscope
