本文關(guān)鍵詞：兩種入路腰椎融合術(shù)治療腰椎疾病的療效比較　出處：《臨床骨科雜志》2016年06期 　論文類(lèi)型：期刊論文

  更多相關(guān)文章： 腰椎融合術(shù) 椎旁肌間隙入路 傳統(tǒng)后正中入路 腰椎疾病 肌肉損傷

【摘要】：目的探討椎旁肌間隙入路和傳統(tǒng)后正中入路腰椎融合術(shù)治療腰椎疾病的療效。方法對(duì)184例需手術(shù)治療的腰椎疾病患者按照隨機(jī)數(shù)字表法分為兩組,分別接受椎旁肌間隙入路(實(shí)驗(yàn)組,91例)和傳統(tǒng)后正中入路(對(duì)照組,93例)行腰椎融合術(shù)。比較兩組手術(shù)時(shí)間、術(shù)中失血量、術(shù)后引流量、臥床時(shí)間、VAS評(píng)分、肌酸激酶含量變化、滿(mǎn)意度等指標(biāo)。結(jié)果 184例患者均獲得隨訪,時(shí)間12~38個(gè)月。實(shí)驗(yàn)組手術(shù)時(shí)間為(114.8±13.4)min、臥床時(shí)間為(2.47±0.48)d,低于對(duì)照組的(134.9±24.2)min、(4.41±2.28)d,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。實(shí)驗(yàn)組術(shù)中失血量為(146.2±48.4)ml、術(shù)后引流量(97.3±17.5)ml,低于對(duì)照組的(211.8±52.4)ml、(147.2±45.5)ml,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后及末次隨訪VAS評(píng)分:實(shí)驗(yàn)組分別為(2.06±0.43)分和(1.76±0.76)分,對(duì)照組分別為(3.26±1.12)分和(3.15±1.15)分,兩組均較術(shù)前降低(P0.05),實(shí)驗(yàn)組較對(duì)照組更低(P0.05)。術(shù)后肌酸激酶實(shí)驗(yàn)組為(315.1±91.5)U/L、對(duì)照組為(574.5±197.6)U/L,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后患者滿(mǎn)意率實(shí)驗(yàn)組為90.1%高于對(duì)照組的79.6%(P0.05)。結(jié)論椎旁肌間隙入路行腰椎融合治療腰椎疾病安全、有效,較傳統(tǒng)后正中入路創(chuàng)傷小。
[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.
【作者單位】： 南京軍區(qū)福州總醫(yī)院九五臨床部骨科三區(qū);
【分類(lèi)號(hào)】：R687.3
【正文快照】： 傳統(tǒng)后正中入路視野清楚、解剖層次清晰,但是術(shù)中牽拉雙側(cè)椎旁軟組織時(shí)間較長(zhǎng),易造成術(shù)后慢性腰痛及腰背肌無(wú)力[1];椎旁肌間隙入路對(duì)肌肉等軟組織損傷較輕,但操作空間相對(duì)狹小,要求術(shù)者具有嫻熟的局部解剖知識(shí)和手術(shù)技巧,學(xué)習(xí)曲線較長(zhǎng),早期容易出現(xiàn)神經(jīng)損傷、硬膜囊破裂等并發(fā)

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