超声吸引装置在脂肪瘤型脊髓拴系综合征中的应用研究

Application of Cavitron ultrasonic surgical aspirator in the management of tethered cord syndrome with lipoma

目的探讨超声吸引装置(Cavitron ultrasonic surgical aspirator,CUSA)在脂肪瘤型脊髓拴系综合征中的应用价值。方法收集2016年5月至2018年11月于湖南省儿童医院神经外科收治的62例脂肪瘤型脊髓拴系综合征患儿作为研究对象,按是否采用CUSA技术分为常规组(n=47)和CUSA组(n=15),对比两组患儿手术时间、术后并发症及预后情况。结果 CUSA组手术时间为(120±43)min,常规组为(220±40)min,差异有统计学意义(t=8.281,P<0.05)。CUSA组并发症发生率为0 (0/15),常规组并发症发生率为12.7%(6/47),差异无统计学意义(X^2=2.12,P=0.321)。常规组中症状加重4例,分别为大小便功能障碍和双下肢畸形,改善10例,稳定33例。CUSA组无一例症状加重;需间歇导尿1例,3个月随访时排尿功能恢复;改善4例;稳定11例。结论通过采用显微外科技术,术中使用CUSA切除脂肪瘤组织等综合措施,可缩短手术时间,减少脂肪瘤型脊髓拴系患儿术后并发症。

Objective To explore the therapeutic effectiveness of Cavitron ultrasonic surgical aspirator(CUSA) for tethered cord syndrome with lipoma.Methods A total of 62 children with lipoma tethered cord syndrome(TCS) were divided into two groups.The routine group consisted of 47 patients undergoing routine procedure of excision of lipoma plus transection of filum teminale.The CUSA group was composed of 15 patients undergoing modified procedure.Lipoma was resected by CUSA and tumors were absorbed.Two groups were compared with regards to operative duration,postoperative complications and prognosis.Results The operative duration was(120±43) min in CUSA group and(220±40) min in routine group.And the difference had statistical difference(t=8.281,P <0.05).The incidence of complications was 0(0/15) in CUSA group and12.7%(6/47) in routine group.And the difference had no statistical difference(X^2=2.12,P=0.321).In routine group,stool/urinary dysfunction and lower extremity malformations worsened(n=4).The symptoms improved(n=4) and stablized(n=11);In CUSA group,none had symptomatic worsening.One case of intermittent catheterization normalized at Month 3.The symptoms improved(n=4) and stablized(n=11).Conelusion-During microsurgery of TCS,CUSA may reduce operative duration and lower operative complications.