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目的探讨脊髓脊膜膨出(MMC)的手术时机和治疗效果。方法回顾性分析82例MMC患儿的临床资料。男38例,女44例;年龄1 d～7岁,平均1.4岁。MMC位于腰、骶部75例,位于颈椎部5例及位于胸椎部和胸腰部各1例,患儿均经相应部位X线正侧位片和MRI确诊,术前常规均行体感诱发电位和肌电图等相关神经电生理检查,全部患儿予手术治疗。术前术后均行尿动力学检查。结果 82例均行手术治疗,术后随访3～12个月,随访期复查患儿症状缓解,其中治愈28例,好转45例,无变化5例,恶化4例,总有效率89.1%。结论常规脊膜膨出切除、椎管扩大探查、脊髓栓系松解和脊膜修补术是MMC目前唯一有效的治疗方法。
Objective To investigate the timing and therapeutic effect of spinal meningocele (MMC). Methods Retrospective analysis of 82 cases of MMC clinical data. 38 males and 44 females; aged 1 d ~ 7 years old, average 1.4 years old. MMC was located in the lumbar and sacral 75 cases, located in the cervical spine in 5 cases and in the thoracic and thoracic lumbar one case, the children were confirmed by the appropriate location of the X-ray films and MRI confirmed conventional preoperative somatosensory evoked potentials and EMG and other related neurophysiological examination, all children undergoing surgical treatment. Preoperative and postoperative urodynamic examination. Results All the 82 patients underwent surgical treatment. The patients were followed up for 3 to 12 months. During the follow-up period, the symptoms were relieved. Among them 28 were cured, 45 were improved, 5 were unchanged, 4 were deteriorated, and the total effective rate was 89.1%. Conclusions Conventional mephincterotomy, exploration of spinal canal enlargement, tethering of the tethered cord and meningocele are the only effective treatments for MMC.