目的：探讨半椎板切开入路切除椎管内肿瘤的优缺点。方法：回顾性分析2004～2006年经手术切除病理证实的椎管内肿瘤196例的临床资料。其中80例行了半椎板入路肿瘤切除，与同期的116例全椎板切除病人进行比较。结果：半椎板切除病人手术住院时间明显缩短，术后起床反应轻微，远期效果较全椎板好，对脊柱的稳定性影响小。结论：单侧半椎板入路切除椎管内肿瘤损伤小，最有利于脊柱稳定性的维持。病人手术后住院时间短，反应轻微，远期疗效好。但也有暴露局限的缺点.
Objective To compare the incidence of social function disorders in head injury patients with and without craniocerebral injury and to explore the value for mental identification. Methods SDSS (Social Disability Screening Schedule), GAF (Global Assessment Function) and GAS (Global Assessment Scale) instruments were used to test the social function of 56 patients without craniocerebral injury and 55 patients with craniocerebral injury. Results One hundred and eleven patients with head injury were included and identified as head injury with or without craniocerebral injury by CT or MRI. The incidence of social function deficit, tested by using SDSS instrument, was 33.9% (19/56) in patients without craniocerebral injury and 45.5% (25/55) in patients with craniocerebral injury respectively. There was no statistically significant difference between the two groups (χ2=1.544, P=0.214). This was also no statitical difference in both GAS group (t=0.021, P=0.983) and GAF group (t=0.391, P=0.697). Conclusions The limited evidence showed that the incidence of social function deficit of the head injury patients combined with craniocerebral injury is higher than those who without craniocerebral injury, but the difference between the two groups has no statistically significant difference.We could not detect a difference in the incidence of social deficit between those head injury patients with or without craniocerebral injury ones.
Objective To systematically evaluate posterior fossa decompression with duraplasty (PFDD) and posterior fossa decompression without duraplasty (PFD) for Chiari malformation type I (CM-I). Methods A meta-analysis was performed according to the guideline of the MOOSE statement. Relevant literature and references were electronically searched in CENTRAL, Science Citation Index Expanded, MEDLINE (Ovid), PubMed, CBM, CNKI and WanFang Data from 1993 to September 2011. Two reviewers independently identified literature according to inclusion and exclusion criteria. The included studies were evaluated using the Newcastle-Ottawa Scale. Original data were extracted and analyzed using RevMan 5.1 software. Besides, the level of evidence was assessed using the GRADE system. Results Ten studies involving 829 patients were included. The results of meta-analyses showed that: a) compared with patients undergoing PFD, patients undergoing PFDD had a significantly lower reoperation rate (RR=0.41, 95%CI 0.23 to 0.74, P=0.003), and a higher rate of syringomyelia decrease (RR=1.27, 95%CI 1.03 to 1.56, P=0.02). But there was no significant difference in clinical improvement (RR=1.11, 95%CI 0.95 to 1.28, P=0.18). b) compared with PFD, patients undergoing PFDD had a higher rate of cerebrospinal fluid–related complications (RR=6.3, 95%CI 2.71 to 14.67, Plt;0.000 1). There were no significant differences in the complication of occipital neuralgia and wound infection (Pgt;0.05). Based on GRADE system, the evidence was at Level C and we made a weak recommendation. Conclusion Posterior fossa decompression with duraplasty is associated with a lower risk of reoperation, a better effect of syringomyelia decrease and a greater risk for cerebrospinal fluid–related complications, compared with PFD. Due to the influencing factors of lower-quality included studies, a prudent choice is suggested, and also more high-quality, large-sample studies are need.