本文選題：Chiari畸形I型　切入點(diǎn)：單純后顱窩減壓術(shù)　出處：《新疆醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:對(duì)Chiari畸形I型兩種不同術(shù)式的療效進(jìn)行回顧性分析,通過(guò)比較兩種術(shù)式的利弊,制定出一套更適合患者的個(gè)性化手術(shù)治療方案。方法:嚴(yán)格篩選新疆醫(yī)科大學(xué)第一附屬醫(yī)院神經(jīng)外科于2014年6月至2016年6月收治的經(jīng)手術(shù)治療的Chiari畸形I型患者79例,失訪5例,共納入研究74例。將其分為A、B兩組,其中A組行單純后顱窩骨性減壓術(shù),B組在A組手術(shù)的基礎(chǔ)上行硬膜擴(kuò)大修補(bǔ)術(shù)+小腦扁桃體切除術(shù),對(duì)兩組患者術(shù)后的療效進(jìn)行分析評(píng)估。結(jié)果:74例手術(shù)患者中,其中男24例,女50例,A組患者34例,B組患者40例,A組患者手術(shù)有效率達(dá)到82.4%,其中僅1例出現(xiàn)術(shù)后并發(fā)癥,B組術(shù)后好轉(zhuǎn)率為80.0%,但術(shù)后并發(fā)癥高于A組,將兩組術(shù)后的療效數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)卡方檢驗(yàn)(X2=0.07,P0.05),得出兩組之間無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論:兩組手術(shù)方式治療Chiari畸形I型對(duì)術(shù)后脊髓空洞的恢復(fù)及臨床癥狀的改善均有一定療效,單純后顱窩減壓術(shù)的有效率高于小腦扁桃體切除術(shù),而且小腦扁桃體切除術(shù)后并發(fā)癥多于單純后顱窩減壓術(shù),且平均住院天數(shù)高,單純后顱窩骨性減壓術(shù)操作相對(duì)簡(jiǎn)單安全、有效,我們認(rèn)為對(duì)有癥狀的Chiari畸形I型患者選擇單純后顱窩減壓術(shù)更安全有效。
[Abstract]:Objective: to retrospectively analyze the curative effect of two different operative methods of Chiari malformation type I, and compare the advantages and disadvantages of the two methods. Methods: 79 cases of Chiari type I malformation treated in neurosurgery department of the first affiliated Hospital of Xinjiang Medical University from June 2014 to June 2016 were selected strictly. The patients were divided into two groups: group A was treated with simple posterior cranial fossa decompression and group B was treated with expanded dural repair on the basis of operation in group A, and cerebellar tonsillectomy was performed on the basis of the operation in group A. Results among 74 patients, 24 were male. The effective rate of operation in group A was 82.4%, and the improvement rate of group B was 80.0%, but the postoperative complication was higher than that of group A. Statistical chi-square test was used to test the curative effect data of the two groups. The results showed that there was no statistical significance between the two groups. Conclusion: the two groups of surgical treatment of Chiari deformity type I have a certain curative effect on the recovery of syringomyelia and the improvement of clinical symptoms. The effective rate of simple posterior cranial fossa decompression was higher than that of cerebellar tonsillectomy, and the complication after cerebellar tonsillectomy was more than that of simple posterior cranial fossa decompression, and the average hospital stay was high. The simple posterior cranial fossa decompression was relatively simple and safe. We believe that simple posterior fossa decompression is more safe and effective for patients with symptomatic type I Chiari malformation.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R651.1

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