目的：研究小脑扁桃体切除对恢复枕大池脑脊液循环的意义。方法选取2012年1月至2014年12月延安市延安大学附属医院收治Arnold-Chiari 畸形患者64例，采用随机数字表法分为观察组和对照组，各32例。观察组给予小脑扁桃体切除治疗，对照组给予小脑扁桃体电灼治疗，比较两组的脑脊液流速及治疗效果。结果术后12 d观察组脑脊液.通率显著高于对照组[100.0％（32／32）比87.5％（28／32）]，观察组小脑扁桃体下缘水平脊髓背侧蛛网膜下腔脑脊液头向流速高于对照组[（8.17±1.56） cm／s比（6.21±1.16） cm／s]，尾向流速显著高于对照组[（9.38±1.48） cm／s比（7.10±1.52） cm／s]，差异有统计学意义（P ＜0.05）。观察组总有效率显著高于对照组[96.9％（31／32）比78.1％（25／32）]，差异有统计学意义（P ＜0.05）。观察组总并发症发生率与对照组比较，差异无统计学意义（ P ＞0.05）。结论小脑扁桃体切除能够更好地恢复枕大池脑脊液循环，值得临床进一步研究探讨。%Objective To study the effect of cerebellar amygdala resection on the cerebrospinal fluid circulation in the cisterna magna.Methods From Jan.2012 to Dec.2014,64 patients with Arnold-Chiari malformation were chosen,and divided into an observation group and a control group according to the random number table method,each group with 32 patients.The observation group was treated with cerebellar resec-tion,and the control group was treated with electric burning for cerebellar amygdala,and the cerebrospinal fluid circulation and treatment effect of the two groups were compared .Results 12 d after the operation,CSF patency of the observation group was significantly higher than the control group[100.0%(32/32) vs 87.5%(28/32)],the cerebrospinal fluid head direction velocity in the spinal dorsal cavum subarachnoidale of low-er tonsil margin of the cerebellum of the observation group was significantly higher than the control group [(8.17 ±1.56) cm/s vs (6.21 ±1.16) cm/s],the tail flow rate of the observation group was significantly higher than the control group[(9.38 ±1.48) cm/s vs (7.10 ±1.52) cm/s].The total efficacy of the observation group was significantly higher than the control group[96.9%(31/32) vs 78.1%(25/32)],the difference was statistically significant ( P <0.05 ) .Conclusion Cerebellar amygdala resection can better restore the cerebrospinal fluid circulation in the occipital cistern ,and is worthy of further clinical research .
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