两种入路腰椎融合术治疗腰椎疾病的疗效比较

发布时间：2017-12-27 00:16

本文关键词：两种入路腰椎融合术治疗腰椎疾病的疗效比较　出处：《临床骨科杂志》2016年06期 　论文类型：期刊论文

【摘要】：目的探讨椎旁肌间隙入路和传统后正中入路腰椎融合术治疗腰椎疾病的疗效。方法对184例需手术治疗的腰椎疾病患者按照随机数字表法分为两组,分别接受椎旁肌间隙入路(实验组,91例)和传统后正中入路(对照组,93例)行腰椎融合术。比较两组手术时间、术中失血量、术后引流量、卧床时间、VAS评分、肌酸激酶含量变化、满意度等指标。结果 184例患者均获得随访,时间12~38个月。实验组手术时间为(114.8±13.4)min、卧床时间为(2.47±0.48)d,低于对照组的(134.9±24.2)min、(4.41±2.28)d,差异均有统计学意义(P0.05)。实验组术中失血量为(146.2±48.4)ml、术后引流量(97.3±17.5)ml,低于对照组的(211.8±52.4)ml、(147.2±45.5)ml,差异均有统计学意义(P0.05)。术后及末次随访VAS评分:实验组分别为(2.06±0.43)分和(1.76±0.76)分,对照组分别为(3.26±1.12)分和(3.15±1.15)分,两组均较术前降低(P0.05),实验组较对照组更低(P0.05)。术后肌酸激酶实验组为(315.1±91.5)U/L、对照组为(574.5±197.6)U/L,差异有统计学意义(P0.05)。术后患者满意率实验组为90.1%高于对照组的79.6%(P0.05)。结论椎旁肌间隙入路行腰椎融合治疗腰椎疾病安全、有效,较传统后正中入路创伤小。
[Abstract]:Objective to explore the therapeutic effect of paravertebral space approach and traditional posterior approach lumbar fusion in the treatment of lumbar disease. Methods 184 cases of lumbar diseases requiring surgical treatment were divided into two groups according to the random number table. They received paraspinal muscle gap approach (experimental group, 91 cases) and traditional posterior median approach (control group, 93 cases), respectively. The operation time, blood loss, flow rate, bed time, VAS score, creatine kinase content, satisfaction and other indexes were compared between the two groups. Results all the 184 patients were followed up for 12~38 months. The operative time in the experimental group was (114.8 + 13.4) min and in bed time was (2.47 + 0.48) d, which was lower than that in the control group (134.9 + 24.2) min, (4.41 + 2.28) d, the difference was statistically significant (P0.05). The intraoperative blood loss in the experimental group was (146.2 + 48.4) ml, and the postoperative drainage volume (97.3 + 17.5) ml was lower than that in the control group (211.8 + 52.4) ml, (147.2 + 45.5) ml, the difference was statistically significant (P0.05). The VAS score of postoperative and final follow-up: the experimental group were (2.06 + 0.43) and (1.76 + 0.76) respectively, the control group were (3.26 + 1.12) and (3.15 + 1.15) points respectively, the two groups were lower than before operation (P0.05), and the experimental group was lower than that of the control group (P0.05). After operation, the experimental group of creatine kinase was (315.1 + 91.5) U/L and the control group was (574.5 + 197.6) U/L, and the difference was statistically significant (P0.05). The postoperative satisfaction rate of the patients in the experimental group was 90.1% higher than that of the control group (79.6% (P0.05)). Conclusion lumbar paravertebral space approach lumbar spinal fusion is safe and effective in the treatment of lumbar disease, and it is less traumatic than the traditional posterior approach.
【作者单位】：南京军区福州总医院九五临床部骨科三区;
【分类号】：R687.3
【正文快照】： 传统后正中入路视野清楚、解剖层次清晰,但是术中牵拉双侧椎旁软组织时间较长,易造成术后慢性腰痛及腰背肌无力[1];椎旁肌间隙入路对肌肉等软组织损伤较轻,但操作空间相对狭小,要求术者具有娴熟的局部解剖知识和手术技巧,学习曲线较长,早期容易出现神经损伤、硬膜囊破裂等并发

【参考文献】