摘要
目的探讨显微入路半椎板手术联合超声骨刀对椎管肿瘤的治疗效果及安全性。方法选取2019年1月至2024年1月延安大学附属医院收治的80例椎管肿瘤患者展开前瞻性分析。按照随机数字表法将其分为观察组与对照组,各40例。对照组采取传统全椎板手术治疗,观察组采取显微入路半椎板手术联合超声骨刀治疗。观察两组的近期疗效、脊柱稳定性,记录手术时间、术中出血量、首次下床时间及住院时间,比较两组手术后3 d及手术后3个月的炎症因子[白细胞介素(IL)-6、IL-1、肿瘤坏死因子α(TNF-α)]水平、手术后3 d及手术后3个月的腰椎功能[脊柱功能指数量表(SFI)与日本骨科协会(JOA)评分],记录两组患者术后并发症发生情况。结果观察组患者总有效率与对照组比较,差异无统计学意义(P>0.05);观察组术后脊柱稳定率为97.50%,高于对照组(85.00%),差异有统计学意义(P<0.05)。观察组手术时间、术中出血量、首次下床时间及住院时间分别为(185.15±10.47)min、(223.82±11.08)mL、(8.12±3.73)d、(21.46±4.14)d,均明显低于对照组[(215.95±11.34)min、(315.35±15.12)mL、(14.85±2.28)d、(33.35±5.54)d],差异均有统计学意义(P<0.05)。手术后3 d,两组患者炎症因子水平均较手术前升高,且观察组IL-6、IL-1、TNF-α水平分别为(237.58±9.12)pg/mL、(31.59±3.24)μg/L、(132.41±18.35)pg/mL,均低于对照组[(485.36±23.15)pg/mL、(38.12±3.64)μg/L、(174.06±22.24)pg/mL],差异均有统计学意义(P<0.05)。手术后3个月,两组患者SFI、JOA评分均较手术后3 d升高,且观察组手术后3个月的SFI评分、JOA评分分别为(67.58±11.12)、(20.52±3.31)分,均明显高于对照组[(52.36±9.35)、(15.69±4.24)分],差异均有统计学意义(P<0.05)。观察组总术后并发症发生率为10.00%,显著低于对照组(30.00%),差异有统计学意义(P<0.05)。结论针对椎管肿瘤患者采取显微入路半椎板手术联合超声骨刀治疗疗效�
Objective To explore the therapeutic effect and safety of microsurgical approach hemilaminectomy combined with ultrasonic bone knife for spinal canal tumors.Methods A prospective analysis was performed on 80 patients with spinal canal tumors admitted to the Affiliated Hospital of Yan'an University from January 2019 to January 2024.According to the random number table method,they were divided into the observation group and the control group,40 cases in each group.The control group was treated with traditional total laminectomy,and the observation group was treated with microsurgical approach hemilaminectomy combined with ultrasonic bone knife.The short-term efficacy and spinal stability of the two groups were observed.The operation time,intraoperative blood loss,first time to get out of bed and hospitalization time were recorded.The levels of inflammatory factors[interleukin(IL)-6,IL-1,tumor necrosis factor-α(TNF-α)]at 3 days and 3 months after operation,the lumbar function[spinal function index(SFI)and Japanese Orthopaedic Association(JOA)score]at 3 days and 3 months after operation were compared between the two groups.The postoperative complications of the two groups were recorded.Results There was no statistically significant difference in the total effective rate between the observation group and the control group(P>0.05).The postoperative spinal stability rate of the observation group was 97.50%,which was higher than that of the control group(85.00%),and the difference was statistically significant(P<0.05).The operation time,intraoperative blood loss,first time to get out of bed and hospitalization time in the observation group were(185.15±10.47)min,(223.82±11.08)mL,(8.12±3.73)d and(21.46±4.14)d,respectively,which were significantly lower than those in the control group[(215.95±11.34)min,(315.35±15.12)mL,(14.85±2.28)d and(33.35±5.54)d],and the differences were statistically significant(P<0.05).At three days after operation,the levels of inflammatory factors in the two groups were higher than those b
作者
韦玮
曹慧琴
杨延庆
张春满
胡国良
朱强
WEI Wei;CAO Hui-qin;YANG Yan-qing(Department of Neurosurgery,Yan'an University Affiliated Hospital,Yan'an Shaanxi 716000,China)
出处
《临床和实验医学杂志》
2024年第21期2301-2305,共5页
Journal of Clinical and Experimental Medicine
基金
陕西省重点研发计划项目(编号:2024SF-YBXM-047)。
关键词
显微入路
半椎板手术
超声骨刀
椎管肿瘤
Microsurgical approach
Hemilaminectomy
Ultrasound osteotome
Spinal canal tumors
