本文選題：腰椎 + 非融合��； 參考：《寧波大學(xué)》2015年碩士論文

【摘要】：目的評(píng)估Dynesys動(dòng)態(tài)固定系統(tǒng)在腰椎間盤突出癥治療中的急性期組織創(chuàng)傷應(yīng)激反應(yīng)及早中期臨床療效。方法2012年12月—20l4年2月采用Dynesys系統(tǒng)治療單節(jié)段腰椎間盤突出患者25例(Dynesys組),同期實(shí)施腰椎經(jīng)椎間孔椎間融合TLIF術(shù)的27例單節(jié)段腰椎間盤突出癥患者作為對(duì)照(TLIF組),記錄兩組手術(shù)時(shí)間、出血量,術(shù)前、術(shù)后6小時(shí)、12小時(shí)、24小時(shí)不同時(shí)間點(diǎn)患者IL-6、TNF-α,術(shù)前及術(shù)后1天、2天、5天CRP等血清濃度指標(biāo),術(shù)前、術(shù)后3個(gè)月、末次各隨訪過程中的時(shí)間點(diǎn)ODI和VAS評(píng)分。對(duì)比兩組數(shù)據(jù)差別,評(píng)估兩組手術(shù)急性期組織創(chuàng)傷應(yīng)激程度及術(shù)后療效情況。結(jié)果Dynesys組平均手術(shù)時(shí)間112.3±20.4min,平均術(shù)中出血量232±63ml少于TLIF組的平均手術(shù)時(shí)間148.8±56.2 min,平均術(shù)中出血量405±85ml(P0.05)。對(duì)比兩組患者術(shù)前血清IL-6、TNF-α、CRP炎性指標(biāo),無明顯差別(P0.05),術(shù)后均有上升,其中TLIF組術(shù)后IL-6、CRP濃度變化較Dynesys組大,組間差別有統(tǒng)計(jì)學(xué)意義(P0.05),但兩組間TNF-α濃度未見顯著差異(P0.05)。與術(shù)前相比,兩組術(shù)后各隨訪時(shí)間點(diǎn)的ODI及VAS評(píng)分大幅改善,改善程度具有統(tǒng)計(jì)學(xué)差別(P0.05),但兩組間對(duì)比差別不顯著(P0.05)。結(jié)論Dynesys動(dòng)態(tài)內(nèi)固定與TLIF融合術(shù)均獲得良好臨床療效,與TLIF術(shù)相比,Dynesys系統(tǒng)手術(shù)組織創(chuàng)傷應(yīng)激反應(yīng)較小,對(duì)于降低術(shù)后創(chuàng)傷應(yīng)激反應(yīng),提高手術(shù)安全性具有積極意義。
[Abstract]:Objective to evaluate the clinical efficacy of Dynesys dynamic fixation system in the treatment of lumbar disc herniation. Methods from December 2012 to February 2014, 25 patients with single segment lumbar disc herniation were treated with Dynesys system, and 27 patients with single segment lumbar disc herniation were treated by transforaminal lumbar intervertebral fusion TLIF. The operation time of the two groups was recorded. The serum levels of IL-6 TNF- 偽 in patients with IL-6 TNF- 偽 were measured at different time points (preoperative, 6 hours, 12 hours and 24 hours after operation). The serum levels of CRP were measured before and 1 day after operation. The ODI and VAS scores were obtained at the time points of preoperative, 3 months, and the last follow-up. To compare the difference of data between the two groups, and evaluate the degree of tissue trauma stress and the curative effect after operation in the acute stage of operation between the two groups. Results the mean operative time in Dynesys group was 112.3 鹵20.4min, and the mean intraoperative blood loss was 232 鹵63ml less than that in TLIF group (148.8 鹵56.2 mins). The average intraoperative blood loss was 405 鹵85ml P0.05min. There was no significant difference in serum levels of IL-6 TNF- 偽 and CRP between the two groups before operation, but there was no significant difference between the two groups (P 0.05), but there was no significant difference in the concentration of TNF- 偽 between the two groups (P 0.05). The level of IL-6 and TNF- 偽 in the TLIF group was larger than that in the Dynesys group after operation, and the difference between the two groups was statistically significant (P0.05), but there was no significant difference in the concentration of TNF- 偽 between the two groups. The ODI and VAS scores of the two groups were significantly improved compared with those before operation, and the degree of improvement was statistically different (P 0.05), but the difference between the two groups was not significant (P 0.05). Conclusion Dynesys dynamic internal fixation and TLIF fusion have good clinical effect. Compared with TLIF system, the traumatic stress response of dynesys system is less, which is of positive significance to reduce the postoperative trauma stress response and improve the safety of operation.
【學(xué)位授予單位】：寧波大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

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