【摘要】 目的评价后颅窝内减压(后颅窝减压+后颅窝颅骨成形术)治疗Chiaii畸形I型并脊髓空洞疾病的中期临床疗效。方法采用后颅窝内减压术治疗40例符合标准的Chiari畸形I型并脊髓空洞。观察手术时间、切口愈合情况,分析相关并发症。采用远期生活质量评估(KPS)和美国Lawton和Brodyl996年制定的日常生活能力量表评分(ADL)评价疗效,并且通过影像学检查对脊髓空洞的变化、脑脊液流速情况以及颅颈交界区稳定性情况进行评价。结果随访KPS分值由术前的(70±10)分提高到到末次随访时(80±10)分(P<0.01),ADL分值由术前的(20.6±2.2)分降至末次随访时(15.8±0.5)分(P<0.01),最终疗效评价优良者占86%。颅颈交界区影像学观察脊髓空洞缩小及消失率为90.5%(19/21)。脑脊液流速较术前加快。结论后颅窝内减压术治疗Chiari畸形Ⅰ型并脊髓空洞有一定疗效。更多还原

【Abstract】 Objective To evaluate the mid-term outcomes of posterior fossa decompression and cranioplasty for Chiari malformation and syringomyelia type Ⅰ.Methods Posterior fossa decompression and cranioplasty were performed in a consecutive series of 40 patients.Clinical outcomes were assessed by Karnofsky Performance Scale(KPS)scores and activies of daily living (ADL)questionnaires before and after operation.Operation time,intraoperative blood loss,incision status and complications were recorded.Radiological examination was obtained for each patient to assess the situation of changes in syringomyelia,postoperative cerebrospinal fluid flow rates and the stability of the craniocervical junction.Results The KPS scores increased significantly from(70± 10)preoperatively to(80±10)postoperatively(P<0.01).The ADL scores were decreased remarkably from(20.6±2.2)preoperatively to(15.8±0.5)postoperatively(P<0.01)and the proportion with optimal effect was 86%.Syringomyelia narrowing and disappearance rate was 90. 5%(19/21).Cerebrospinal fluid flow speed improved compared with that before operation. Conclusion Posterior fossa decompression and cranioplasty is an effective and convenient method for Chiari malformation and syringomyelia type Ⅰ.更多还原