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不同手术方案对Chair畸形Ⅰ型患者术后临床疗效的观察 预览

Therapeutic effects of different operation schemes on typeⅠChair malformation
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摘要 目的探讨不同手术方案对Chair畸形Ⅰ型患者术后的临床疗效,为Chair畸形Ⅰ型患者的治疗提供更优越的手术方案。方法选取2015年5月至2018年4月就诊的128例诊断为Chair畸形Ⅰ型的患者,依据随机数字表法患者随机分为2组,每组64例。2组患者给予术前相关检查,其中对照组给予改良后颅窝减压术治疗,研究组给予后颅窝减压术联合硬膜成形术及小脑扁桃体切除术治疗,2组患者随访12个月,评价2组患者的住院时间、短期临床症状改善情况、并发症发生率、脊髓空洞缓解率及肢体感觉障碍缓解率。结果治疗后2组患者的短期临床症状、脊髓空洞缓解率及肢体感觉障碍缓解率均较前明显改善(P<0.05);研究组患者的住院时间、短期临床症状改善情况和并发症发生率均明显优于对照组(P<0.05),2组患者术后1年的肢体感觉障碍缓解率及脊髓空洞缓解率与对照组比较差异无统计学意义(P>0.05)。结论后颅窝减压术联合硬膜成形术及小脑扁桃体切除术与改良后颅窝减压术比较,临床疗效较为显著,可有效改善患者的相关临床症状,减少并发症的发生率,并且有效缩短患者的住院时间,减少患者及其家庭的经济负担,但是两种术式对于患者的肢体感觉障碍的缓解率及脊髓空洞缓解率未见明显异常,说明对于临床症状及体征不同的患者应采取不同的治疗方案,因人而异与个体化的手段相结合。 Objective To investigate the therapeutic effects of different operation schemes on typeⅠChair malformation in order to look for more predominant treatment way for the patients with typeⅠChair malformation.Methods A total of 128 patients with typeⅠChair malformation who were treated in our hospital from May 2015 to April 2018 were enrolled in the study.According to random number table,these patients were randomly divided into two groups,with 64 patients in each group.The patients in both groups were given preoperative related examination,then,the patients in control group were treated by modified posterior fossa decompression operation,however,the patients in research group,on the basis of control group,were treated by epidural plasty and cerebellar tonsillectomy,with 12-month follow up after operation for both groups.The improvement status of clinical symptome,incidence rate of complication,syringomyelia remission rate and body feeling disorder remission rate were observed and compared between the two groups.Results After treatment,the clinical symptome,syringomyelia remission rate and body feeling disorder remission rate were obviously improved in both groups,as compared with those before treatment(P<0.05),moreover,the length of staying in hospital,improvement status of clinical symptome and incidence rate of complication in research group were superior to those in control group(P<0.05).However there were no significant differences syringomyelia remission rate and body feeling disorder remission rate between the two groups(P>0.05).Conclusion As compared with modified posterior fossa decompression operation,the posterior fossa decompression combined with epidural plasty and cerebellar tonsillectomy can obtain obvious therapeutic effects on typeⅠChair malformation,which can effectively improve patient’s clinical symptoms,reduce the incidence of complications,and effectively shorten the hospitalization time of patients,reduce the economic burden of patients and their families,but the two kinds of operatio
作者 牛海涛 杨明 张艳艳 于金然 NIU Haitao;YANG Ming;ZHANG Yanyan(Department of Neurosurgery,Cangzhou Central Hospital,Hebei,Cangzhou 061001,China)
出处 《河北医药》 CAS 2019年第5期695-698,702共5页 Hebei Medical Journal
基金 沧州市科学技术研究与发展指导计划项目(编号:172302165).
关键词 Chair畸形Ⅰ型 不同手术方案 治疗结果 Chair malformation different operation schemes treatment outcome
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