改良颅窝减压术在Chiari畸形Ⅰ型患者中的应用及对其脑脊液动力学的影响

摘要

目的:分析改良颅窝减压术在Chiari畸形Ⅰ型患者中的应用及其对脑脊液动力学的影响.方法:收集我院2013年3月至2015年3月诊治的82例Chiari畸形Ⅰ型患者,按照抽签法分为对照组和观察组,各41例,对照组予以传统颅窝减压术,观察组予以改良颅窝减压术,比较两组临床疗效、并发症、脑脊液动力学[包含脑导管层面、脑桥腹侧平面、C3腹侧平面头端最大峰值流速(VDma)x)、尾端最大峰值流速(VUmax)、每博出量(SV)]以及颅脊角变化.结果:观察组疾病控制率(95.12％)显著高于对照组(80.49％)(P＜0.05),并发症发生率(4.88％)低于对照组(19.51％)(P＜0.05).术后,观察组脑导管层面、脑桥腹和C3腹侧平面VDnax、VUmax、SV和颅脊角、枕骨大孔径值均明显优于对照组(P＜0.05).结论:改良颅窝减压术在Chiari畸形Ⅰ型患者中的临床效果值得肯定,能够改善患者的脑脊液动力学.%Objective:To analyze the application and the influence of modified cranial fossa decompression on the cerebrospinal fluid dynamics of patients with type Ⅰ chiari malformation.Methods:82 patients with Chiari malformation type Ⅰ from March 2013 to March 2015 were collected and divided into the control group and the observation group according to the drawed method with 41 cases in each group.The control group was treated by the traditional cranial fossa decompression,the observation group was treated by modified cranial fossa decompression,the clinical curative effect and complications,cerebrospinal fluid dynamics and cranial spinal Angle change were compared between two groups.Results:The disease control rates (95.12％) of observation group was significantly higher than that of the control group (80.49％) (P＜0.05),the incidence of complications (4.88％) of observation group was lower than that of the control group (19.51％) (P＜0.05).The postoperative brain catheter level,pons,abdomen and C3 ventral plane VDmax,VUmax,SV and cranial ridge Angle,the occipital large aperture value of observation group were significantly better than those of the control group (P＜0.05).Conclusion:Modified cranial fossa decompression had good clinical effect on Chiari deformity Ⅰ types,which could improve the cerebrospinal fluid dynamics.