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中国临床研究英文版:2024,37(5):703-708
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跨节段分流术治疗外伤和感染导致的脊髓空洞症
(1.新乡医学院,河南 新乡 453003;2.郑州大学附属郑州中心医院神经脊柱外科,河南 郑州 450000)
Trans-segmental shunt surgery for the treatment of syringomeylia resulting from trauma and infection
摘要
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Received:February 02, 2024   Published Online:May 20, 2024
中文摘要: 目的 本研究结合脑脊液动力学,探讨脊髓空洞跨节段分流术治疗由于外伤和感染导致的脊髓空洞症的临床疗效。 方法 收集2019年7月至2021年6月就诊于郑州市中心医院脊髓空洞专科的脊髓空洞症患者共17例的临床资料,入组者均行脊髓空洞跨节段分流手术。分析患者手术前后的临床特征、肌电图、影像学特征。使用芝加哥Chiari畸形预后评分(CCOS)、日本骨科协会(JOA)评分改善指数评估患者临床预后。采用Pearson法分析JOA评分改善指数及CCOS评分与脑脊液峰值流速差值的相关性。 结果 跨节段分流术后,14例临床症状明显改善,3例术后症状未改善。术后JOA评分高于术前(17.65±1.80 vs 8.94±2.36, t=11.609, P<0.01)。手术后肢体麻木、分离性感觉障碍、步态障碍、头晕症状、下肢无力、共济失调、感觉神经传导、运动神经传导、空洞最大径及枕骨大孔区及中脑导水管收缩期、舒张期脑脊液峰值流速较术前改善(P<0.05)。JOA评分改善指数及CCOS评分与脑脊液峰值流速差值显著相关(P<0.05)。 结论 对于外伤和感染导致的脊髓空洞症患者,脊髓空洞跨节段分流术一定程度上改善患者的脑脊液动力学,促进脊髓空洞缩小,改善临床症状。
Abstract:Objective To investigate the clinical effect of trans segmental shunt surgery in the treatment of syringomyelia due to trauma and infection in perspective of cerebrospinal fluid dynamics.Methods A total of 17 syringomyelia patients admitted to the Syringomyelia Department in Zhengzhou Central Hospital from July 2019 to June 2021 were collected, all patients underwent trans-segmental shunt surgery for syringomyelia. The clinical features, electromyography and imaging features of patients before and after operation were analyzed. The Chicago Chiari outcome scale (CCOS) and Japanese Orthopaedic Association (JOA) score improvement index were used to evaluate the clinical prognosis of patients. Pearson method was used to analyze the correlation between the JOA score improvement index, CCOS score and the difference of peak velocity of cerebrospinal fluid.Results After trans segmental shunt, the clinical symptoms of 14 cases were significantly improved, and 3 cases did not improve. The JOA score was significantly higher after surgery than before surgery (17.65±1.80 vs 8.94±2.36, t=11.609, P<0.01). Limb numbness, dissociative sensory disorder, gait disorder, dizziness, lower limb weakness, ataxia, sensory nerve conduction, motor nerve conduction, maximum diameter of cavity and peak cerebrospinal fluid flow in the foramen magnum and the midbrain aquaquet during systolic and diastolic periods were significantly improved after surgery (P<0.05). JOA score improvement index and CCOS score were significantly correlated with the difference of cerebrospinal fluid peak velocity (P<0.05). Conclusion For patients with syringomyelia caused by trauma or infection, trans-segmental shunt of syringomyelia can improve the cerebrospinal fluid dynamics of patients with syringomyelia to a certain extent, promote the reduction of syringomyelia and improve the clinical symptoms of patients.
文章编号:     中图分类号:R651    文献标志码:A
基金项目:河南省科技攻关项目(222102310652)
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