摘要
目的 研究不同类型Arnold-Chiari畸形(ACM)的手术治疗方法。方法 回顾性分析36例ACM病人的临床类型、术式选择、手术结果、术后并发症及再次手术情况。结果 全组ACM分属Ⅰ型28例,Ⅱ型6例,Ⅲ型2例,分别采取术式A:单纯枕颈减压术(FMD)19例,术式B:FMD加硬膜扩容术10例,术式C:FMD加小脑扁桃体切除术5例,术式D:脊髓脊膜膨出修补术2例;各术式有效率分别为78.9％、100％、83.3％、0;并发症发生率分别为31.6％、10.0％、16.7％、0;再次手术率分别为42.1％、0、16.7％、0。结论 对于Ⅰ型和Ⅱ型ACM病人,术式B治疗效果明显优于术式A,Ⅲ型病人的治疗方法有待进一步探讨。
Objective To study the surgical treatment of different type of Arnold-Chiari malformation(ACM). Methods 36 cases were analysised retrospetively on their clinical type, treatment method, effect, postoperative complication, and reoperation. Results There are 28 cases of type Ⅰ , 6 cases of type Ⅱ , and 2 cases of type Ⅲ . 19 cases were treated with method A(FMD: foraman magnum decompression) , 10 cases with method B(FMD and DVD:dural volume dilatation), 5 cases with method C(FMD and TR: tonsils resection), 2 cases with method D(RRM:re-
section and repair of myelomeningocele) . Respectively, effective rate is 78.9% , 100% ,83.3% ,0, occurence rate of complication is 31.6% , 10. 0%,16.7%,0, and reoperation rate is 42.2%,0,16.7%,0. Conclusion Method B is superior to method A for type Ⅰ and Ⅱ ACM, and it is necessary to develope better operation method for type Ⅲ .
