老年性腰椎管狭窄的椎间孔镜治疗分析  

Treatment of senile lumbar spinal stenosis by percutaneous transforaminal endoscopic discectomy

作　　者：何齐芳[1] 

机构地区：[1]浙江省杭州市第一人民医院骨科,310006

出　　处：《中华全科医学》2015年第6期902-905,共4页Chinese Journal of General Practice

摘　　要：目的分析椎间孔镜微创治疗老年腰椎管狭窄患者的临床疗效。方法 2012年6月—2014年1月杭州市第一人民医院收治腰椎管狭窄的患者120例,其中男性67例,女性53例,患者年龄60-82岁。根据随机数字法分为2组,观察组60例,其中男性32例,女性28例,平均年龄（67.3±3.8）岁,平均病程（5.4±2.3）年;对照组60例,男性35例,女性25例,平均年龄为（65.8±3.4）岁,平均病程为（5.6±3.1）年。观察组60例患者采用椎间孔镜方法治疗,对照组60例患者采用常规手术治疗。记录2组患者的术中及术后恢复情况进行比较分析。结果观察组患者手术时间为（61.2±10.3）min,明显低于对照组患者（89.3±21.3）min;术中出血量为（13.1±4.8）ml,同样低于对照组术中出血量（189.3±29.1）ml,并且观察组患者住院时间为（4.53±1.30）d,也短于对照组（9.45±3.43）d,2组患者的手术时间、术中出血量和住院时间比较差异均具有统计学意义（P〈0.05）。观察组患者术后12 h、24 h、48 h、72 h的VAS评分明显低于对照组患者评分,2组患者疼痛感比较差异具有统计学意义（P〈0.05）。术后6个月观察组ODI总评分为12.31±2.98,对照组为19.48±2.87,2组比较差异具有统计学意义（P〈0.05）;术后24个月观察组总评分为2.87±1.06,对照组为4.98±1.34,2组比较差异具有统计学意义（P〈0.05）。结论椎间孔镜手术具有创伤小、恢复快、疗效明确等优点,是治疗老年性腰椎管狭窄症的较好的手术方式。Objective To study the curative effect of percutaneous transforaminal endoscopic discectomy（PTED） in the treatment of senile lumbar spinal stenosis. Methods 120 cases of patients with lumbar spinal canal stenosis,including 67 males and 53 females aged 60 -82 years old,were enrolled and randomly divided into two groups with 60 cases in each group. The control group ： 32 males and 28 females, mean age （ 67.3 ± 3.8 ） years, average course of disease （ 5.4 ± 2.3 ） years ; the observation group ： 35 males and 25 females, mean age （65.8 ± 3.4 ） years, average course of disease （ 5.6 ± 3.1 ） years. PTED was performed in the observation group, while the conventional surgical treatment was performed in the control group. The operation time, volume of bleeding and postoperative recovery was compared between the two groups. Results The operation time of the observation group was （61.2 ± 10.3 ） rain, which was significantly lower than （89.3 ±21.3）min of the control group（P 〈0.05 ）. The intraoperative blood loss in the observation group was （13.1 ± 4.8 ） ml, which was lower than （ 189.3 ± 29.1 ） ml in the control group （ P 〈 0.05 ）. The duration of hospital stays in the observation group was （4.53 ± 1.30） days, which was shorter than （9.45 ± 3.43 ） days in the control group （ P 〈 0.05 ）. The postoperative VAS score at 12 h,24 h ,48 h and 72 h of the observation group was significantly lower than those of the control group, the difference was significant（ P 〈 0.05 ）. Six months after the operation, the total ODI score was 12.31 ± 2.98 in the observation group and 19.48 ± 2.87 in the control group, the difference was statistically significant （P 〈 0.05）. 24 months after the surgery,The ODI score was 2.87 ± 1.06 in observation group and 4.98 ± 1.34 in the control group,the difference was statistically significant（P 〈0.05）. Conclusion PTED,with advantages of small tranma,quick recovery and clear curative effect,is one of good surgery

关 键 词：椎间孔镜 老年患者 腰椎管狭窄 

分 类 号：R681.53[医药卫生—骨科学]