摘要
目的比较单侧双通道内镜(UBE)下单纯减压术与传统开放减压融合内固定手术治疗腰椎管狭窄症(LSS)的疗效差异。方法回顾性分析我院2020年6月至2022年6月腰椎管狭窄症患者的手术治疗资料。依术式分为微创组(UBE)与开放组,对比围手术期的VAS评分(视觉疼痛评分,VAS)、ODI指数(oswestry功能障碍指数问卷表,ODI)、SAS评分(焦虑自评量表,SAS)和SDS评分(抑郁自评量表,SDS)以及手术出血量、手术时间、引流量、下地时间、住院时长、住院费用,并发症及随访的VAS评分、ODI指数、SDS评分、SAS评分、改良MacNab标准。分析两种术式治疗腰椎管狭窄症的疗效。结果共68例患者被纳入,微创组36例,开放组32例。微创组术前VAS评分为(4.6±0.8)分,开放组为(5.3±0.6)分,余一般资料间无明显统计学意义。术后微创组和开放组患者各项评分(VAS、ODI、SAS、SDS)较术前明显改善(P<0.05);微创组在手术时间、术中出血量、24 h流量、抗生素应用时间、下地时间、住院时长、医疗费用、术后1周及术后3月的腰背痛VAS评分上相比开放组有统计学差异(P<0.05);本研究据末次随访统计的改良MacNab评价,两组疗效优良率相近,无明显统计学差异(P>0.05)。结论UBE治疗腰椎管狭窄症的效果不亚于传统开放手术,且在减少手术出血量、缩短住院时间、节省医疗费用等优于开放手术,因此,该术式能有效治疗腰椎管狭窄症。
Objective To compare the curative effects of simple decompression surgery under unilateral biportal endoscopy(UBE)versus traditional open decompression surgery with internal fixationin the treatment of umbar spinal stenosis(LSS).Methods The surgical treatment data of patients with lumbar spinal stenosis in our hospital from June 2020 to June 2022 were retrospectively analyzed.They were divided into minimally invasive group(UBE)and open group according to the surgical method.The perioperative Visual Pain Scale(VAS)score,Oswestry Disability Index(ODI index),Self-rating Anxiety Scale(SAS)score and Self-rating Depression Scale(SDS)score,surgical blood loss,operation time,drainage volume,ground time,hospital stay,hospital cost,complications and follow-up VAS score,ODI index,SDS score,SAS score and modified MacNab standard wascompared between the two groups.The efficacy of two surgical methods for lumbar spinal stenosis was analyzed.Results A total of 68 patients were included,including 36 in the minimally invasive group and 32 in the open group.The VAS score before surgery was(4.6±0.8)points in the minimally invasive group and(5.3±0.6)points in the open group,with no significant statistical difference among other general data.Scores(VAS,ODI,SAS,SDS)in minimally invasive group and open group were significantly improved compared with those before surgery(P<0.05).Compared with the open group,the minimally invasive group had statistically significant differences in operation time,intraoperative blood loss,24-hour drainage volume,antibiotic application time,ground time,length of hospital stay,medical cost,low back pain VAS score 1 week and 3 months after surgery(P<0.05).In this study,according to the evaluation of modified MacNab at the last follow-up,the rate of excellent and good results was similar between the two groups,with no significant statistical difference(P>0.05).Conclusion The efficacy of UBE in the treatment of lumbar spinal stenosis is not inferior to that of traditional open surgery,and it is superior to o
作者
刘沛昕
黄思远
周立强
孙军辉
刘雪莹
秦毅
Liu Peixin;Huang Siyuan;Zhou Liqiang;Sun Junhui;Liu Xueying;Qin Yi(Department of Spinal Osteopathy,Zhuhai People’s Hospital-Zhuhai Hospital Affiliated to Jinan University,Zhuhai Guangdong 519000,China)
出处
《遵义医科大学学报》
2023年第7期697-703,共7页
Journal of Zunyi Medical University
基金
国家自然科学基金面上项目(NO:82174142)
广东自然科学基金资助项目(NO:2021A1515410001)。
关键词
椎管狭窄症
单侧双通道内镜
减压融合
开放手术
疗效
lumbar spinal stenosis
unilateral biportal endoscopy
decompression fusion
open surgery
therapeutic effect
