【摘要】：目的通過對比兩組患者術后功能及癥狀恢復情況和影像學資料,評估MED術中保留并縫合黃韌帶的臨床療效,為臨床上預防和減少硬膜外瘢痕粘連提供合適的方法。方法本組研究共納入腰椎間盤突出癥病例共40例。脫落病例5例,試驗組18例,對照組各17例。均于術前完成腰椎正側位片、腰椎動力位片、CT、核磁共振等相關檢查,明確病變階段及神經根卡壓狀況。試驗組在MED術中保留并縫合深層黃韌帶,對照組則采用傳統(tǒng)MED術式。通過對患者術前術后功能及癥狀改善情況,并在術后6個月時復查腰椎核磁共振,共隨訪期6個月。收集數(shù)據(jù)并進行處理和分析比較,以此來分析兩種治療方案在預防MED術后椎管內瘢痕粘連上的優(yōu)劣。結果試驗組較對照組效果更令人滿意,在術后影像學測量方面。試驗組及對照組之間存在差異(P0.05),在VAS及Oswestry評分方而,兩組患者較術前均有明顯提高,試驗組與對照組有可比性(P0.05)。結論本項目通過保留深層黃韌帶對MED術后椎管內粘連的影響及其療效的相關研究,證明保留深層黃韌帶能確實減少MED術后椎管內瘢痕,可以預防椎管內粘連,能改善術后癥狀,適宜在臨床推廣。
[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.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R274.9

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