择期和急诊手术治疗寰枢椎节段椎管内占位性病变的疗效比较

发布时间：2019-02-13 21:57

【摘要】：目的比较择期和急诊行寰枢椎节段椎管内占位性病变手术的疗效。方法选取2010年5月至2015年4月在该院接受治疗的寰枢椎节段椎管内占位性病变患者32例,将患者分为急诊手术组(A组)14例和择期手术组(B组)18例。比较两组患者手术时间、术中出血量、JOA评分、ODI指数及VAS评分、术后影像学(MRI)改变情况和两组患者对疗效的满意度。结果术后A组患者的JOA评分[(25.23±4.47)分]高于B组[(22.10±3.56)分],差异有统计学意义(P0.05)。两组患者的ODI指数及VAS评分都有所下降,ODI指数A组(18.56±3.10)分,B组(21.56±4.37)分、VAS评分A组(1.89±0.53)分,B组(3.16±0.89)分,两组ODI指数比较差异有统计学意义(P0.05);两组VAS评分比较差异有统计学意义(P0.05)。两组患者术前及术后1个月时脊髓功能分级(Frankel分级)比较,差异均无统计学意义(P0.05)。A组手术时间[(120.23±9.02)min]与B组[(126.25±12.12)min]相比差异无统计学意义(P0.05);A组患者的术中出血量[(211.26±12.25)mL]与B组[(220.43±17.58)mL]相比差异无统计学意义(P0.05)。治疗后1个月A组患者的满意度(92.56%)高于B组患者(72.22%),差异有统计学意义(P0.05)。结论急诊行寰枢椎节段椎管内占位性病变手术,能有效提高治疗效果,并且治疗后患者的满意度比较高,值得推广使用。
[Abstract]:Objective to compare the effect of selective and emergency operation for atlantoaxial segment intraspinal space occupying lesions. Methods from May 2010 to April 2015, 32 patients with atlantoaxial intraspinal space occupying lesions were selected and divided into emergency operation group (group A, n = 14) and elective operation group (group B, n = 18). The operative time, intraoperative bleeding volume, JOA score, ODI index and VAS score, the changes of imaging (MRI) and the satisfaction of the two groups were compared. Results the JOA score of group A [(25.23 卤4.47)] was significantly higher than that of group B [(22.10 卤3.56)] (P0.05). The ODI index and VAS score of two groups were decreased, ODI index group A (18.56 卤3.10), group B (21.56 卤4.37), VAS score A (1.89 卤0.53), group B (3.16 卤0.89), group A (1.89 卤0.53), group B (3.16 卤0.89). The difference of ODI index between the two groups was statistically significant (P0.05). There was significant difference in VAS score between the two groups (P0.05). The spinal cord function grading (Frankel) was compared between the two groups before operation and 1 month after operation. There was no significant difference between the two groups (P0.05). A group [(120.23 卤9.02) min] and B group [(126.25 卤12.12) min] (P0.05); The amount of intraoperative bleeding in group A [(211.26 卤12.25) mL] was not significantly different from that in group B [(220.43 卤17.58) mL] (P0.05). One month after treatment, the satisfaction of group A (92.56%) was higher than that of group B (72.22%), the difference was statistically significant (P0.05). Conclusion the emergency operation of atlantoaxial segment intraspinal space occupying lesion can effectively improve the therapeutic effect, and the satisfaction of the patients after treatment is relatively high, which is worth popularizing.
【作者单位】：遵义医学院附属医院脊柱外科;
【分类号】：R687.3

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