Arnold-Chiari畸形的诊断与治疗

The diagnosis and treatment of the Arnold- Chiari malformation

本文报道我院1975～1990年收治的Arnold-Chiari畸形(ACM)43例,均经手术证实。所表现的临床征象为枕大孔区压迫、脊髓中央损害及小脑损害综合征。全组均经颅后窝减压和C_(1～3)椎板切除术,术后 3例因呼吸困难或肺部感染死亡。37例行追踪观察,随访期 1～10年(平均4.5年),29例(78％)术前症状消失或改善。文中对本病的病理学特征、诊断与治疗进行了分析与讨论。我们认为本病有效的处理方法为彻底的颅后窝减压及C_(1～3)椎板切除术。

43 cases of Arnold-Chiari malformation (ACM)were treated surgicaly between 1975 to 1990.The presenting symptoms and signs was of foramenmagnum compression syndrome, including upperspinal cord and cerebellar lesions. All patientsunderwent postenor fossa decompression and C_(1～3)laminectomy. After operation, three patients diedof difficuliy aspiration or lung infection. Thirty-seven patients were reviewed postoperatively. Theperiod of follow-up vaned from 1 to 10 years. with amean of 4.5 years. Early disappearance orimprovenment of preoperative symptoms occurredin 29 patients (78%). The pathological feature,diagnosis and treatment of ACM are discussed inthe articale. The authors conclude that whileposterior fossa decompression and C_(1～3) laminectomymay be effective in the patients. and is recommendedin the treatment of the ACM.