摘要
目的探讨微创手术与传统开放手术在腰椎管狭窄治疗中的临床效果。方法随机选取该院2017年2月—2018年10月期间行腰椎管狭窄手术治疗的40例患者,随机分为传统组(19例)和微创组(21例)。传统组行传统后正中入路开放术式,微创组行微创椎旁肌间隙入路手术,对比两组手术相关指标、术后腰椎功能障碍及腿痛疼痛改善情况。结果微创组切口长度(4.68±1.74)cm、术中出血量(160.23±24.13)mL、术后引流量(92.02±10.86)mL、术后住院时间(6.01±1.06)d时间显著低于传统组(14.23±3.02)cm、(345.03±34.02)mL、(134.02±31.02)mL、(8.56±1.57)d,差异有统计学意义(t=12.403、19.964、5.829、6.073,P<0.05)。微创组术后6个月腰椎ODI指数(13.43±2.73)%显著低于传统组(24.02±5.63)%,差异有统计学意义(t=7.686,P<0.05)。微创组和传统组术后6个月下肢VAS评分差异无统计学意义(P>0.05)。微创组术后1个月(80.26±7.55)分和3个月KPS评分(89.46±9.57)分显著高于传统组(71.67±9.57)分、(80.45±8.57)分,差异有统计学意义(t=3.167、3.124,P<0.05)。结论与传统开放术式,微创椎旁肌间隙入路手术具有创伤小、引流量小、康复快、疗效好等优势,可有效改善患者预后,临床应用价值较高,具备微创和高效的优势。
Objective To explore the clinical effects of minimally invasive surgery and traditional open surgery in the treatment of lumbar spinal stenosis.Methods A total of 40 patients who underwent lumbar spinal stenosis surgery in the hospital from February 2017 to October 2018 were conveniently selected and randomly divided into traditional group(19 cases)and minimally invasive group(21 cases).The traditional group underwent traditional posterior median approach open surgery,and the minimally invasive group underwent minimally invasive paraspinal space approach surgery.The two groups were compared with the improvement of the two groups'operation-related indicators,postoperative lumbar spine dysfunction,and leg pain.Results Incision length(4.68±1.74)cm,intraoperative blood loss(160.23±24.13)mL,postoperative drainage volume(92.02±10.86)mL,postoperative hospital stay time(6.01±1.06)d in the minimally invasive group were significantly lower than those in the traditional group(14.23±3.02)cm,(345.03±34.02)mL,(134.02±31.02)mL,(8.56±1.57)d,the difference was statistically significant(t=12.403,19.964,5.829,6.073,P<0.05).The lumbar spine ODI index(13.43±2.73)%in the minimally invasive group was significantly lower than that in the traditional group(24.02±5.63)%at 6 months after surgery,and the difference was statistically significant(t=7.686,P<0.05).There was no significant difference in the VAS scores of the lower limbs between the minimally invasive group and the traditional group at 6 months postoperatively(P>0.05).The KPS score(89.46±9.57)points of the minimally invasive group at 1 month(80.26±7.55)points and 3 months after the operation was significantly higher than that of the traditional group(71.67±9.57)points,(80.45±8.57)points,and the difference was statistically significant(t=3.167,3.124,P<0.05).Conclusion Compared with traditional open surgery,minimally invasive paraspinal muscle access surgery has the advantages of less trauma,less drainage,faster recovery,and better curative effect.It can effectively i
作者
徐沁
林小龙
沙卫平
王黎明
严飞
黄群
周志平
XU Qin;LIN Xiaolong;SHA Weiping;WANG Liming;YAN Fei;HUANG Qun;ZHOU Zhiping(Department of Spine Surgery,Zhangjiagang Hospital,Soochow University,Zhangjiagang,Jiangsu Province,215600 China)
出处
《中外医疗》
2021年第34期31-34,共4页
China & Foreign Medical Treatment
基金
2021年苏州市“苏州市科教兴卫”青年科技项目(KJXW2020058)。
关键词
微创手术
传统开放手术
腰椎管狭窄
临床疗效
引流
出血量
Minimally invasive surgery
Traditional open surgery
Lumbar spinal stenosis
Clinical efficacy
Drainage
Bleeding
