不同术式治疗复杂颅底畸形合并小脑扁桃体疝的疗效比较

The efficacy of different surgical treatment for complex skull base malformation cerebellar tonsillar herniation

目的比较不同术式治疗复杂颅底畸形合并小脑扁桃体疝的疗效。方法选取我院20例复杂颅底畸形合并小脑扁桃体疝患者为研究对象,随机均分为A组(后颅窝减压术组)和B组(前后路联合手术组)。结果A组4例疗效较好,评分为12-15分,5例疗效较差,评分为9-11分,1例昏迷,评分为8分以下。B组7例疗效较好,评分为12-15分,3例疗效较差,评分为9-11分。随访9个月至5年,A组2例症状明显改善,6例症状部分改善,2例患者症状无明显变化,有效率为80.0%;B组4例症状明显改善,5例症状部分改善,1例患者症状无明显变化,有效率为90.0%。B组治疗效果明显优于A组,差异有统计学意义(P<0.05)。结论对复杂颅底畸形合并小脑扁桃体疝的患者行前后路联合手术安全可靠、效果好,优于传统的后颅窝减压术。

Objective To compare the clinical efficacy of different surgical treatment of complex skull base malformation ton-sillar herniation. Methods 20 cases of complex skull malformation with tonsillar herniation were randomly divided into group A （Posterior fossa decompression surgery group） and grouP B （combined anterior group）. Results Group A has four cases scoring 12-15 points,five cases scoring 9-11 Points,one case scoring of 8 points or less. Group B,seven cases scoring 12-15 points,three cases scoring 9-11 points. Followed for 9 months to 5years,the effective rate of group A was 80.0%,the effective rate of group B was 90.0%. Group B is better than Group A,the difference was statistically significant （P〈0.05）. Conclusion The comPlex skull malformation tonsillar herniation underwent combined anterior safe,reliable,effective and suPerior to the traditional Posterior fossa decomPression.