微创改良术与传统手术治疗Chiari畸形合并脊髓空洞症的效果分析

摘要

目的：探讨微创改良术治疗Chiari畸形合并脊髓空洞症的效果，并与传统手术对比，为Chiari畸形合并脊髓空洞症的最佳术式选择提供依据。方法：根据手术方案将本院2009年2月-2012年2月期间收治并确诊的65例Chiari畸形合并脊髓空洞症患者随机分为传统组（n=32，接受传统手术治疗）和改良组（n=33，接受微创改良手术治疗），于出院时分析两组的常见临床症状（神经功能、膀胱功能、感觉及运动障碍）的恢复时间，近期疗效，出院后1年随访其远期疗效，住院期间及远期并发症情况。结果：两组的常见临床症状恢复时间及住院期间近期疗效的差异均无统计学意义（P>0.05）。改良组出院后远期并发症总发生率低于传统组，比较差异有统计学意义（P<0.05），头痛、发热及脑脊液漏的发生率均较低。改良组疾病控制率为96.97%，远高于传统组的75.00%，比较差异有统计学意义（P<0.05）。改良组的术后的脊髓空洞长度小于传统组（P<0.05）。结论：两种手术的近期疗效相当，但微创改良术的远期疗效较优，并发症较少，可在Chiari畸形合并脊髓空洞症治疗中推广。%Objective:To explore the effect of modified minimally invasive surgery and conventional surgery on Chiari malformation with syringomyelia.Method:According to the surgery program,65 patients with Chiari malformation with syringomyelia were assigned into the traditional group(n=32,receiving conventional surgery) and the modified group(n=33,receiving modified minimally invasive surgery). The recovery time of common clinical symptoms(neurological function,bladder function,sensory and motor disorders) at discharge,short-term effect,1-year follow-up after discharge and complications during hospitalization were compared between groups.Result:There were no significant differences on the recovery time of common clinical symptoms and short-term effect between both groups(P>0.05). However,the incidence of complications in the modified group was lower than the traditional group(P<0.05),especially the fever,headache and cerebrospinal fluid leakage. The disease control rate of the traditional group was 75.00%while the modified group was 96.97%after treatment,and the difference between the two groups was statistically significant(P<0.05). The length of syringomyelia in the modified group was superior to that of the traditional group(P<0.05).Conclusion:The short-term efficacies of both surgeries are equivalent,but the long-term efficacy of modified minimally invasive surgery is better than the traditional group with fewer complications.