两种不同术式治疗chiari畸形的对比疗效探析.pdfVIP

目 录 1 两种不同术式治疗chiari 畸形的对比疗效分析„„„„„1 1.1 中文摘要„„„„„„„„„„„„„„„„„„„„„3 1.2 英文摘要„„„„„„„„„„„„„„„„„„„„„4 1.3 前言„„„„„„„„„„„„„„„„„„„„„„„6 1.4 材料与方法„„„„„„„„„„„„„„„„„„„„7 1.5 结果„„„„„„„„„„„„„„„„„„„„„„„12 1.6 讨论„„„„„„„„„„„„„„„„„„„„„„„15 1.7 结论„„„„„„„„„„„„„„„„„„„„„„„31 1.8 参考文献„„„„„„„„„„„„„„„„„„„„„34 1.9 英汉缩略词对照表„„„„„„„„„„„„„„„„„35 2 致谢„„„„„„„„„„„„„„„„„„„„„„„40 3 Chiari 畸形的诊疗现状 （综述） „„„„„„„„„„„„„„„„„„„„„„„„„41 2 两种不同术式治疗chiari 畸形的对比疗效分析 摘 要 目的探讨改良后颅窝减压术+枕大池成形术与枕下减压+扩大硬膜修 补术对比治疗chiari 畸形合并脊髓空洞症的适应症、疗效和并发症 的差异。方法 选择2008 年 1 月至2012 年 1 月我院神经外科根据患 者具体情况采用改良后颅窝减压术+枕大池成形术与后颅窝减压+扩 大硬膜修补术治疗的76 例chiari 畸形合并脊髓空洞的患者，对比分 析其疗效、并发症和脊髓空洞改变情况。结果 改良后颅窝减压+枕大 池成形术组近期疗效总有效率为80.6%，远期疗效总有效率为71.9%； 后颅窝减压+扩大硬膜成形术组近期疗效总有效率为 77.5%，远期疗 效总有效率为67.6%。两组在疗效、并发症和脊髓空洞改善情况，差 异无统计学意义。结论 根据患者的个体情况采用改良后颅窝减压术+ 枕大池成形术与后颅窝减压+扩大硬膜修补术治疗 chiari 畸形合并 脊髓空洞症在疗效，并发症，差异无统计学意义。 关键词 chiari 畸形 脊髓空洞 手术 疗效分析 并发症 3 Two different surgical treatment chiari malformation compared the efficacy analysis Abstract: objective: Discuss the issue of improved posterior fossa decompression and cistern magna angioplasty with suboccipital decompression plus expansion of the dural repair technique compared chiari malformation with syringomyelia treatment indications, efficacy and complications of the difference.Methods : Neurosurgery of our hospital in accordance with the specific circumstances of the patients using a modified posterior fossa decompression in January 2008 to January 2012 plus the cisterna magna angioplasty and posterior cranial fossa dec