摘要
目的探讨显微镜辅助下经固定通道手术治疗腰椎间盘突出症的临床效果及可行性。方法在本院2020年1月-2021年1月收治的腰椎间盘突出症患者中选择87例作为研究对象,均使用显微镜辅助下经固定通道手术治疗,记录各项手术指标、手术效果、术前术后VAS(视觉模拟评分法)、ODI(Oswestry功能障碍指数)及WHO(世界卫生组织)生存质量测定量表简表(WHOQOL-BREF)。结果87例患者中,86例手术成功,手术切口均Ⅰ期愈合,术后随访10~18个月,平均(13.4±2.5)个月,术后无感染、并发症(神经根损伤等)发生,有1例脑脊液漏;切口长度(3.21±0.15)cm,手术时间(78.72±7.35)min,术中出血量(27.26±10.97)mL,伤口引流量(29.64±5.68)mL,住院时间(8.42±1.45)d;遵循改良MacNab的评估原则,优39例、良43例、可5例、差0例,优良率为96.55%(84/87);术后3个月、6个月、12个月的VAS疼痛评分明显低于术前(P<0.05);术后3个月、6个月、12个月的ODI评分明显低于术前(P<0.05);术后3个月、6个月、12个月的WHOQOL--BREF评分明显高于术前(P<0.05)。结论腰椎间盘突出症患者行显微镜下辅助经固定通道治疗的效果显著,未造成较创伤,疼痛情况也耐受,并能有效提高生活质量,具有积极的临床意义。
Objective To investigate clinical effect and feasibility of microscope-assisted surgery through fixed channels for lumbar disc herniation.Methods The paper chose 87 patients with lumbar disc herniation admitted to our hospital from January 2020 to January 2021 as study subjects,treated with microscope-assisted surgery through fixed channels.Various surgical indicators,surgical effect,preoperative and postoperative VAS(visual analogue scoring method),ODI(Oswestry dysfunction index)and WHO(World Health Organization)Life quality Measurement Scale(WHOQOL-BREF)were recorded.Results Among 87 cases,86 were successfully operated,and surgical incisions were all healed in the first stage.Follow-up period was 10-18 months,with an average of(13.4±2.5)months.No infection and complications(nerve root injury,etc.)occurred after surgery,and 1 case had cerebrospinal fluid leakage;incision length was(3.21±0.15)cm,operation time was(78.72±7.35)min,intraoperative bleeding volume was(27.26±10.97)ml,wound drainage volume was(29.64±5.68)mL,length of stay was(8.42±1.45)d.Following evaluation principle of modified MacNab,39 cases were excellent,43 cases were good,5 cases were fair,and 0 case was poor.Excellent and good rate was 96.55%(84/87),VAS pain scores at 3,6 and 12 months after operation was significantly lower than before operation(P<0.05);ODI scores at 3,6 and 12 months after operation were significantly lower than before operation(P<0.05);WHOQOL-BREF scores at 3,6 and 12 months after operation were significantly higher than before operation(P<0.05).Conclusion Fixed channel under microscope can achieve significant effect in treatment of lumbar intervertebral disc herniation,with less trauma,and tolerable pains,and can improve life quality effectively,which has positive clinical significance.
作者
包天链
杨物鹏
Bao Tianlian;Yang Wupeng(Surgery Department,Baotou Medical College,Baotou,Inner Mongolia 014040;Spinal Surgery Department,Ordos City Central Hospital,Baotou,Inner Mongolia 017000)
出处
《智慧健康》
2023年第3期137-140,共4页
Smart Healthcare
关键词
腰椎间盘突出症
显微镜辅助下经固定通道手术
临床疗效
Lumbar disc herniation
Microscope-assisted surgery through fixed channels
Clinical effect
