神经内镜与显微镜治疗脊髓栓系综合征的对比性研究

发布时间：2018-07-15 10:18

【摘要】：目的:比较应用神经内镜与应用显微镜手术治疗脊髓栓系综合征(TCS)的临床资料并分析其优缺点,为临床诊疗工作提供参考。方法:回顾性分析2007年1月至2016年1月山西省人民医院神经外科手术治疗的124例TCS患者临床资料,其中显微镜组85例,内镜组39例,观察比较两组患者的手术疗效、手术时间、术中出血量、住院时间、肿瘤切除率、术后并发症以及随访结果。计量资料采用t检验,计数资料采用χ2检验。结果:内镜组患者手术时间、术中出血量、住院时间等指标均明显优于显微镜组,且两组相比较差异均具有显著性(P0.05)。而组间的临床症状改善、栓系松解率、肿瘤全切率、脊柱裂处理、近期并发症(脑脊液漏、术后疼痛、感染)相比较差异无显著性(P0.05)。随访期间,显微镜组患者远期并发症(再栓系、腰椎失稳)发生率均明显高于内镜组(P0.05)。结论:与显微镜下栓系松解术相比,采用神经内镜手术治疗脊髓栓系综合征具有十分显著的治疗效果。内镜下栓系松解术在保证相同的手术疗效前提下,其手术时间较短,术中出血量较少,且缩短了患者住院时间,降低了远期并发症的发生率,有利于患者的术后恢复。
[Abstract]:Objective: to compare the clinical data of tethered cord syndrome (TCS) treated by endoscopy and microscope, and to provide reference for clinical diagnosis and treatment. Methods: the clinical data of 124 patients with TCS treated by neurosurgery in Shanxi Provincial people's Hospital from January 2007 to January 2016 were retrospectively analyzed, including 85 cases in microscope group and 39 cases in endoscopic group. Intraoperative bleeding, length of stay, tumor resection rate, postoperative complications, and follow-up results. T test was used for measuring data and 蠂 2 test was used for counting data. Results: the operative time intraoperative bleeding and hospital stay in the endoscopic group were significantly better than those in the microscope group and there was significant difference between the two groups (P0.05). There was no significant difference in clinical symptoms, thrombolysis rate, total tumor resection rate, spina bifida management and recent complications (cerebrospinal fluid leakage, postoperative pain, infection) between groups (P0.05). During the follow-up period, the incidence of long-term complications (resuscitation, lumbar instability) in the microscope group was significantly higher than that in the endoscopic group (P0.05). Conclusion: compared with microscopical thrombectomy, neuroendoscopy is effective in the treatment of tethered spinal cord syndrome. Under the premise of the same operative effect, endoscopic thrombectomy has shorter operation time, less intraoperative bleeding, shorter hospitalization time and lower incidence of long-term complications, which is beneficial to the postoperative recovery of patients.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R651.2

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