脊髓空洞内外压力测定及空洞-腹腔分流术后长期随访研究

目的根据空洞内外压力差及术后长期随访结果探讨和总结用“T”型管行脊髓空洞-腹腔分流术式的理论基础和效果。方法对26例患者术中分别测定空洞内外压力后,再用“T”型管行脊髓空洞-腹腔分流术。将本组的26例与我们以前报道的22例相同病例一起定期行临床及影像学随访,随访期为2个月～12年(平均7．1年)。结果 26例经测定发现空洞内压力均等或低于空洞外 (蛛网膜下腔)压力。两组术后长期影像学随访发现脊髓空洞均明显缩小,仅1例空洞术后3个月因分流管堵塞而复发。两组总的手术分流有效率为97．67％,临床症状明显改善率79．1％。结论用“T”型管行脊髓空洞-腹腔分流术治疗较大型脊髓空洞症是合理且长期有效的方法。

Pressure determination of intra/extra syrinx and long-term follow-up results of syrinx-peritoneal shunting

Objective To explore and summarize the basic theory and practical effects of syrinx-peritoneal shunt (S-P shunt) with "T "tube by studying 26 cases with syringomyelia (SM) based on the pressure difference of intra/extra syrinx and long-term follow-up results. Methods During the operation, pressures of intra/extra syrinx of 26 SM cases were detected respectively, followed by the S-P shunt with"T" tube. The clinical conditions of the 26 cases and the other 22 same cases reported by us before were analyzed and the imaging data during the follow up ranging from 2 months to 12 years (7.1 years on average) were reviewed. Results The internal pressure of syrinx was always equal to or lower than external one of syrinx (subarachnoid cavity pressure) in the 26 cases. The long-term follow-up studies in the 2 groups showed that all of the patients' syrinx cavities were obviously shrinked, except one recurrence 3 months after the operation due to the tube blocking. The success rate of the S-P shunt was 97.67% in the 2 groups, and the improvement rate of clinical symptoms was 79.1%. Conclusion Using syrinx-peritoneal shunt with"T"tube is a kind of reasonable and reliable method to treat the large syrinx cavity.