摘要
本文报道采用改进的手术方法治疗368例脊柱裂合并尿失禁的经验。改进的手术包括由脊柱裂上下扩大椎板切除范围,切除压迫脊髓、马尾的各种病理性组织,切除存在的脂肪瘤、脊髓脊膜膨出囊、囊肿,切断牵张的终丝,仔细分解游离圆锥、马尾、解除脊髓拴系,以恢复其血运与神经功能。基本治愈与显效208例,占56.52%;好转128例,占34.78%;无效32例,占8.7%。初次手术者较再次手术者效果好。对复杂病例,采用显微手术方法,有利提高疗效。
Surgical treatment of 368 cases of spinal bifidawith urinary incontinece are reported.Most of themwere associated with tethered spinal cord.Authorhas used a new method to treat this condition.233cases were male and 135 cases were female.Patients aged 1-5 years old in 95 cases,6-9 in109 cases,11-20 in 133 cases and 21-40 in 31cases.The site of lesion mainly located in lumbarand sacral region.There were spinal bifida occultain 234 cases(63.6%),spinal bifida with myelomen-ingocele in 63 cases,spinal bifida with lipomatouslesion and lipomyelomeningocele in 71 cases.193cases were operated primarily and 175 cases wereoperated secondarily.All cases complicated withbladder dysfunction and 123 cases had boweldysfunction also.Patient associated with completeparalysis of both legs in 60 cases and associatedwith trophic ulcers on the buttock or feet in 39cases.The main point of operative measures werewide decompresion,resection of all pathologicaltissue which causes compresion on and tethered thespinal cord and nerve tissue tight filumterminalis,and disect the nerve tissue free fromadhesions,and end result belong to cure and nearcure in 103 cases,improved in 105 cases,fair in128 cases and no any effect in 32 cases.
出处
《中华神经外科杂志》
CSCD
北大核心
1991年第2期81-83,共3页
Chinese Journal of Neurosurgery
