两种不同术式治疗chiari畸形的对比疗效分析

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1、中图分类号：R89；R36；R39硕士学位论文两种不同术式治疗chiari畸形的对比疗效分析院（系）、所临床医学院研究生姓名王茂明学科、专业外科学导师姓名杨福兵教授二Ο一二年四月1目录1两种不同术式治疗chiari畸形的对比疗效分析„„„„„11.1中文摘要„„„„„„„„„„„„„„„„„„„„„31.2英文摘要„„„„„„„„„„„„„„„„„„„„„41.3前言„„„„„„„„„„„„„„„„„„„„„„„61.4材料与方法„„„„„„„„„„„„„„„„„„„„71.5结果„„„„„„„„„„„„„„„„„„„„„„„121.6讨论„„„„„

2、„„„„„„„„„„„„„„„„„„151.7结论„„„„„„„„„„„„„„„„„„„„„„„311.8参考文献„„„„„„„„„„„„„„„„„„„„„341.9英汉缩略词对照表„„„„„„„„„„„„„„„„„352致谢„„„„„„„„„„„„„„„„„„„„„„„403Chiari畸形的诊疗现状（综述）„„„„„„„„„„„„„„„„„„„„„„„„„412两种不同术式治疗chiari畸形的对比疗效分析摘要目的探讨改良后颅窝减压术+枕大池成形术与枕下减压+扩大硬膜修补术对比治疗chiari畸形合并脊髓空洞症的适应症、疗效和并发症的差异。方法选

3、择2008年1月至2012年1月我院神经外科根据患者具体情况采用改良后颅窝减压术+枕大池成形术与后颅窝减压+扩大硬膜修补术治疗的76例chiari畸形合并脊髓空洞的患者，对比分析其疗效、并发症和脊髓空洞改变情况。结果改良后颅窝减压+枕大池成形术组近期疗效总有效率为80.6%，远期疗效总有效率为71.9%；后颅窝减压+扩大硬膜成形术组近期疗效总有效率为77.5%，远期疗效总有效率为67.6%。两组在疗效、并发症和脊髓空洞改善情况，差异无统计学意义。结论根据患者的个体情况采用改良后颅窝减压术+枕大池成形术与后颅窝减压+扩大硬膜修补术治疗chiari畸形合

4、并脊髓空洞症在疗效，并发症，差异无统计学意义。关键词chiari畸形脊髓空洞手术疗效分析并发症3TwodifferentsurgicaltreatmentchiarimalformationcomparedtheefficacyanalysisAbstract:objective:Discusstheissueofimprovedposteriorfossadecompressionandcisternmagnaangioplastywithsuboccipitaldecompressionplusexpansionoftheduralrepairt

5、echniquecomparedchiarimalformationwithsyringomyeliatreatmentindications,efficacyandcomplicationsofthedifference.Methods:NeurosurgeryofourhospitalinaccordancewiththespecificcircumstancesofthepatientsusingamodifiedposteriorfossadecompressioninJanuary2008toJanuary2012plusthecister

6、namagnaangioplastyandposteriorcranialfossadecompressionandexpansionoftheduralrepairtreatmentof76casesofchiarimalformationcombinedpatientswithsyringomyelia,thecomparativeanalysisofitsefficacy,complications,andsyringomyeliachangethesituation.Results:Fossadecompressionandimprovedt

7、hecisternamagnaformingsurgerygrouptotaleffectiveratewas80.6%,long-termtotaleffectiverateof71.9%;posteriorfossadecompressionandexpansionoftheduralplastygrouptotaleffectiverate77.5%,thelong-termefficacyoftotaleffectiveratewas67.6%.Twogroupsintermsofefficacy,complications,andspina

8、lcordhollowimprovethesituation,thedifferencewasnotstat