根袖重建术用于包含神经根骶管囊肿患者治疗中的效果.docVIP

根袖重建术用于包含神经根骶管囊肿患者治疗中的效果 　　[摘要] 目的 探讨根袖重建术在包含神经根骶管囊肿患者中的临床治疗效果。方法 整群选取2011年1月―2015年12月该院神经外科收治的68例骶管囊肿患者，按照根袖重建术标准程序进行开放性手术治疗，观察手术结果。结果 57例患者伤口愈合良好，11例患者因伤口红肿出现延迟愈合，术后JOA评分明显提高，神经功能状况改善率在71.35%～76.20%之间，术后随访及影像学检查显示囊肿均完全消失，未出现囊肿残留或术腔残留积液的情况。结论 对包含神经根骶管囊肿患者实施根袖重建术效果显著，可明显提高患者神经功能状况，有效清除囊肿，值得在临床上推广使用。 　　[关键词] 根袖重建术；脊神经根；骶管囊肿；治疗效果 　　[中图分类号] R651.1 [文献标识码] A [文章编号] 1674-0742（2016）04（c）-0041-03 　　[Abstract] Objective To study the clinical effect of root sleeve reconstruction in treatment of patients with nerve root sacral cyst. Methods 68 cases of patients with sacral cyst admitted and treated in the department of neurosurgery of our hospital from January 2011 to December 2015 were selected and were treated with open operation according to the standard procedures of root sleeve reconstruction， and the operative effect was observed. Results Wound healing was good in 57 cases， late healing was in 11 cases due to the wound swelling， postoperative JOA score was obviously improved， and the improvement rate of neurological functional status was between 71.35% and 76.20%， the postoperative follow-up and imaging examination showed that the all the cysts disappeared completely， and the cyst residue or nsal cavity residual effusion did not occur. Conclusion The effect of root sleeve reconstruction in treatment of patients with nerve root sacral cyst is obvious， which can obviously improve the neurological functional status of patients and effectively remove cysts， which is worth clinical promotion and application. 　　[Key words] Root sleeve reconstruction； Spinal nerve root； Sacral cyst； Treatment effect 　　骶管囊肿起病于脊髓被膜，属于椎管内硬脊膜囊肿范畴，在核磁共振检查出现之前，我国对骶管囊肿的发病率并没有相关统计，临床检查技术的进步使越来越多的骶管囊肿患者得到明确诊断[1]。临床上将骶管囊肿分为两种类型，一种是不包含脊神经根的骶管囊肿，即Nabors IB型，另一种是包含脊神经根的骶管囊肿，即Nabors II型，后者是因神经根远端异常扩张所形成的囊肿，发病部位一般位于S2～3水平脊神经节，大部分患者为成年人[2]。骶管囊肿比较常见，而且无明显症状，如果保守治疗无效或腰腿疼痛已严重影响正常生活，出现生理功能障碍，可考虑手术治疗以恢复囊肿内神经纤维内环境。为评估根袖重建术治疗包含神经根骶管囊肿患者的临床疗效，该研究整群选取2011年1月―2015年12月该院神经外科收治的68例骶管囊肿患者为研究对象，采取开放性手术进行治疗，取得了满意的