【摘要】 目的  回顾性分析2002-1至2011-12期间于新生儿期住院手术的神经管闭合不全病儿，针对各病理类型探讨手术指征、术后远期效果及其治疗意义。方法  所有新生儿期入院病儿经头颅或脊髓MRI检查明确诊断，76例患儿中11例未治疗，24例急诊手术、41例限期手术，术前术后对大小便和下肢运动功能评价。结果  11例未手术患儿5例无手术指征，6例家长放弃，术后半年以上得到远期随访病例50例，占治疗者76.9%, 平均随访时间43.06±28.36月，原有症状均有改善，46.1%存在大小便障碍，33.3%留有运动功能障碍，22%智力落后。结论  新生儿期就诊的神经管闭合不全患儿应在评估生存质量基础上取舍手术, 有手术指征者应及时治疗，对防止神经功能继发性损害具有积极意义。

【Abstract】Objective To analyze patients in the neonatal period with neural tube dysraphism admitted during Jun.2002 to Dec.2011 retrospectivelly, we discuss the surgical indication and methods and late result according to each type of pathology to clarify the therapeutic significance .Methods All of patients who had been diagnosed by examination of brain and spinal MRI ,among them 11 cases were untreated, 24 cases were accepted emergency operation and 41 of them time limit for operation. To evaluate the pre- and post-operative function of the bladder and anal sphincter, motor function. Results  In untreated cases , 5 of them have no surgical indication and 6 were given up by their parients. . 50 cases( 76.9%) have been followed-up over more than half a year which mean followed-up time was 43.06±28.36 month, and had improved symptoms .There are 46.1% patients who had disturbance of bladder and anal functions and 33.3% drop of motor functions, moreover 22% of patients have mental retardation.  Conclusions  To the newborn with dysraphic malformation , the surgery must be taken or given up according to the judgement to their life quality, the timely operation to patients would be significant helpful to their late functional improvement. 

【Key Words】 neonatal period  myelomeningocele  (lipo-) myelomeningocele

              closed dysraphic malformation   late result

发表于：2012-12-12 21:24