保留并缝合深层黄韧带对腰椎间盘突出症术后椎管内粘连的影响及其疗效的相关性研究
发布时间：2018-08-28 20:22
【摘要】：目的通过对比两组患者术后功能及症状恢复情况和影像学资料,评估MED术中保留并缝合黄韧带的临床疗效,为临床上预防和减少硬膜外瘢痕粘连提供合适的方法。方法本组研究共纳入腰椎间盘突出症病例共40例。脱落病例5例,试验组18例,对照组各17例。均于术前完成腰椎正侧位片、腰椎动力位片、CT、核磁共振等相关检查,明确病变阶段及神经根卡压状况。试验组在MED术中保留并缝合深层黄韧带,对照组则采用传统MED术式。通过对患者术前术后功能及症状改善情况,并在术后6个月时复查腰椎核磁共振,共随访期6个月。收集数据并进行处理和分析比较,以此来分析两种治疗方案在预防MED术后椎管内瘢痕粘连上的优劣。结果试验组较对照组效果更令人满意,在术后影像学测量方面。试验组及对照组之间存在差异(P0.05),在VAS及Oswestry评分方而,两组患者较术前均有明显提高,试验组与对照组有可比性(P0.05)。结论本项目通过保留深层黄韧带对MED术后椎管内粘连的影响及其疗效的相关研究,证明保留深层黄韧带能确实减少MED术后椎管内瘢痕,可以预防椎管内粘连,能改善术后症状,适宜在临床推广。
[Abstract]:Objective To evaluate the clinical effect of preserving and suturing ligamentum flavum in MED by comparing the postoperative functional and symptomatic recovery and imaging data of the two groups, and to provide a suitable method for preventing and reducing epidural scar adhesion. The experimental group retained and sutured the deep ligamentum flavum during MED, while the control group used the traditional MED. The function and symptoms of the patients were improved before and after operation. Six months after operation, the patients were followed up for six months. Data were collected, processed and compared to analyze the advantages and disadvantages of the two treatments in preventing intraspinal scar adhesion after MED. In the difference (P 0.05), the VAS and Oswestry scores of the two groups were significantly higher than those of the preoperative group, the experimental group and the control group were comparable (P 0.05). Conclusion Through the study of the effect of preserving deep ligamentum flavum on intraspinal adhesion after MED and its curative effect, it is proved that preserving deep ligamentum flavum can reduce intraspinal scar after MED. Scar can prevent intraspinal adhesion, improve postoperative symptoms, and is suitable for clinical promotion.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9
[Abstract]:Objective To evaluate the clinical effect of preserving and suturing ligamentum flavum in MED by comparing the postoperative functional and symptomatic recovery and imaging data of the two groups, and to provide a suitable method for preventing and reducing epidural scar adhesion. The experimental group retained and sutured the deep ligamentum flavum during MED, while the control group used the traditional MED. The function and symptoms of the patients were improved before and after operation. Six months after operation, the patients were followed up for six months. Data were collected, processed and compared to analyze the advantages and disadvantages of the two treatments in preventing intraspinal scar adhesion after MED. In the difference (P 0.05), the VAS and Oswestry scores of the two groups were significantly higher than those of the preoperative group, the experimental group and the control group were comparable (P 0.05). Conclusion Through the study of the effect of preserving deep ligamentum flavum on intraspinal adhesion after MED and its curative effect, it is proved that preserving deep ligamentum flavum can reduce intraspinal scar after MED. Scar can prevent intraspinal adhesion, improve postoperative symptoms, and is suitable for clinical promotion.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9
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