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目的分析儿童脊髓栓系综合征(TCS)后遗马蹄内翻足的临床特点,并对其疗效进行评估。方法对2005年5月-2010年12月手术治疗的64例TCS后遗马蹄内翻足畸形患儿的病例资料进行回顾性研究,从发病情况、临床表现、并发症、手术方式等几个方面进行分析,并根据国际马蹄内翻足畸形研究学组(ICFSG)的评分标准对其进行疗效评估。结果单侧足受累35例(左侧13例,右侧22例),双侧足受累29例。原发型TCS 53例,继发型TCS 11例。并发症:感觉障碍者26例,大小便功能障碍者23例(部分丧失18例,失禁5例),并发育性髋关节脱位和肌营养不良者1例,小脑扁桃体疝2例,脊柱侧弯10例,肋骨发育畸形3例和脊髓空洞22例。疗效:优10例16足,良21例36足,可25例31足,差8例10足。本组病例中,11例既往在多家医院未能明确发病原因,误诊或者漏诊率为17.2%(11/64例)。结论儿童TCS继发足畸形以马蹄内翻足居多。临床误诊漏诊现象较普遍,应提高对该病的认识,明确病因及对因治疗至关重要。
Objective To analyze the clinical characteristics of horseshoe cataract after pediatric tethered cord syndrome (TCS) and evaluate its curative effect. Methods A retrospective study was conducted on the data of 64 cases of children with TCL after operation from May 2005 to December 2010. From the aspects of incidence, clinical manifestation, complications and operation methods And analyzed according to the International Clubfoot Variation Research Group (ICFSG) scoring criteria for its efficacy evaluation. Results 35 cases of unilateral foot involvement (left 13 cases, right 22 cases), bilateral foot involvement in 29 cases. 53 cases of primary TCS, 11 cases of secondary TCS. Complications: 26 cases of sensory disturbances, 23 cases of impotence (partial loss in 18 cases, incontinence in 5 cases), and developed hip dislocation and muscular dystrophy in 1 case, cerebellar tonsillar hernia in 2 cases, scoliosis 10 cases, 3 cases of rib deformity and 22 cases of syringomyelia. Efficacy: excellent in 10 cases 16 feet, good in 21 cases 36 feet, 25 cases 31 feet, 8 cases poor 10 feet. In this group of patients, 11 cases failed to clear the cause of the disease in many hospitals. The rate of misdiagnosis or misdiagnosis was 17.2% (11/64 cases). Conclusion Children with TCS secondary foot deformity to the majority of clubfoot. Misdiagnosis of clinical diagnosis of misdiagnosis is more common, should raise awareness of the disease, a clear cause and treatment is crucial.