杨永栋;徐林;俞兴;

• 1:北京中医药大学附属东直门医院骨科

摘要(Abstract)：

[目的]通过分析、总结成人与儿童脊髓拴系综合征的临床特点,比较、分析二者的手术疗效。[方法]回顾分析2003年10月~2012年3月就诊于东直门医院骨科的76例脊髓拴系综合征患者,儿童组47例(年龄<18岁),年龄8个月~17岁,平均(8.18±5.3)岁;成人组29人(年龄≥18岁),年龄18~54岁,平均(31.59±11.79)岁。所有患者术前均行影像学和尿流动力学检查(婴幼儿除外)。手术疗效通过患者术前、术后2周、术后3个月及末次随访的神经症状评分进行评估,平均随访时间(60±62)个月。[结果]疼痛是成人组患者最常见的主诉,存在严重神经障碍的患者很少。括约肌功能失调是儿童组患者最常见的主诉。儿童组47例中有44例接受了手术治疗,成人组29例中有24例接受了手术治疗。所有患者术后神经症状的稳定状态都得到了明显改善,儿童组患者术后括约肌功能改善显著,而成人组患者术后疼痛改善更明显。总体来看,两组患者术后3个月、末次随访时神经功能评分分别与术前比较,差异均有统计学意义(P<0.01)。[结论]儿童脊髓拴系综合征患者一经发现应尽快手术治疗,以防止症状出现和(或)加重。对于神经症状不断发展的成人患者,建议行手术治疗,手术可有效缓解疼痛并延缓神经症状的进展,但手术治疗应慎重,尤其是伴有脂肪瘤和神经管囊肿的复杂成人脊髓拴系综合征患者,应特别注意手术方式及手术策略,由经验丰富的脊柱外科医生完成。同时,建议不存在神经症状的成人患者保守治疗,以保持长期、稳定的神经状态。

关键词(KeyWords)： 成人;儿童;脊髓拴系综合征;临床特点;手术疗效

Abstract:

Keywords:

基金项目(Foundation): 北京中医药大学自主创新项目(编号:2014-JYBZZJS-031)

作者(Author): 杨永栋;徐林;俞兴;

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DOI:

参考文献(References)：

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