后颅窝扩大重建术治疗Chiar畸形合并脊髓空洞症的临床研究

目的 探讨后颅窝扩大重建术治疗Chiar畸形合并脊髓空洞症的临床效果及安全性.方法 选取2005年1月至2012年1月由维吾尔自治区人民医院北院收治的Chiar畸形合并脊髓空洞患者80例,采用随机数字表法将患者分为对照组和后颅窝扩大重建组,每组各40例;对照组采用后颅窝减压术治疗,后颅窝扩大重建组采用后颅窝扩大重建术治疗;比较两组患者临床改善优良率,上肢、下肢及感觉功能恢复效果及术后并发症发生情况等.结果 对照组和后颅窝扩大重建组患者临床改善优良率分别为65.0%和72.5%,改善优良率比较无统计学意义（P＞0.05）;对照组与后颅窝扩大重建组患者上肢、下肢及感觉功能恢复效果比较无统计学意义（P＞0.05）,但后颅窝扩大重建组患者术后感染、皮下积液及脑脊液漏等并发症发生率显著低于对照组（P＜0.05）.结论 后颅窝扩大重建术治疗Chiar畸形合并脊髓空洞症临床效果确切,可有效改善患者临床症状、体征,且术后并发症发生率低,具有临床应用价值.

Clinical Study of Posterior Fossa Reconstruction on Chiari Malformation Combined with Syringomyelia

Objective To investigate therapeutic effect ariel security of posterior fossa reconstruction on Chiari malformation combined with syringomyelia. Methods During January 2005 and January 2012, 80 patients with Chiari malformation and syringomyelia from Xinjiang Uygur Autonomous Region People＇s Hospital North Division were selected and randomly divided into two groups, including control group （40 patients）with posterior fossa decompression treatment and posterior fossa reconstruction group （40 patients）with posterior fossa reconstruction treatment. The excellent and good improving rate of clinical symptoms, the function improving rate of upper limb, lower limb and sensory, and complication incidence after treatment of both groups were com- pared. Results The excellent and good improving rates of clinical symptoms of control group and posterior fossa reconstruction group were 65.0% and 72.5%. There was no significant difference in excellent and good impro- ving rate of clinical symptoms between control group and posterior fossa reconstruction group（ P 〉 O. 05 ）. Them was also no significant difference in the function improving rate of upper limb, lower limb and sensory between control group and posterior fossa reconstruction group （ P 〉 0.05 ）. But the complication （ such as postoperative infection,subcutaneous fluid and cerebrospinal fluid leakage） incidence after treatment of posterior fossa recon- struction group was significantly lower than control group（ P 〈 O. 05 ）. Conclusion The posterior fossa reconstruc- tion on chiarl malformation combined with syringomyelia has confirmative effects ,which can efficiently improve clini- cal symptoms and sigaas,with lower risk of complication after treatment,and is worthy of clinical application.