改良显微镜下手术治疗腰椎管狭窄症的疗效分析  

Efficacy of modified operation under microscope for treatment of lumbar spinal stenosis

作　　者：黄湄景 陆晓生[2] 韦文[2] 

机构地区：[1]广西百色市民族卫生学校外科学教研室,广西百色533000 [2]右江民族医学院附属西南医院,广西百色533000

出　　处：《右江民族医学院学报》2015年第2期240-242,共3页Journal of Youjiang Medical University for Nationalities

基　　金：广西壮族自治区卫生厅自筹经费计划课题(桂卫科教[2010〔11〕Z2010489])

摘　　要：目的：观察改良显微镜下手术治疗腰椎管狭窄症的临床效果。方法将2008年2月~2013年2月入院治疗腰椎管狭窄症的239例患者,随机分为两组,A 组采用改良显微镜下手术,B 组采用传统开放手术,比较两者在手术失血、住院时间、医药费、并发症及疗效等方面的指标。结果 A、B 组各3例发生硬脊膜破裂,B 组4例术后腰椎不稳。术后无神经根损伤、感染等并发症。手术失血、住院时间、医药费比较差异具有统计学意义（P 0.05）。结论两种方法疗效满意,但改良显微镜下手术具有创伤小、出血少、住院日短、医疗费用少、并发症少等优点。Objective To observe the efficacy of modified operation under microscope for lumbar spinal stenosis. Methods A tptal of 239 cases of patients with lumbar spinal canal stenosis cared at our hospital from February 2008 to February 2013 were randomly divided into two groups.Patients in group A were treated with modified operation under microscope,whereas patients in group B were treated with traditional open operation. The blood loss during the operation,hospitalization time,medical expenses,complications and curative efficacy were compared in the two groups. Results Endorachis rupture occurred in 3 cases of each group,4 cases in group B had lumbar spinal instability after the operation.There was no complication such as nerve root injury and infection in the two groups after the operation.Statistical differences in comparison of surgical blood loss,hospitalization time,medical expenses were obtained between the two groups （P 〈0.001）.A total of 224 cases were followed up for more than 12 months.According to the evaluation criteria of surgical treatment of low back pain formulated by Chinese Medical Association,the assessment of the operation efficacy was done,results showed that in group A,excellent was achieved in 54 cases,good in 51 cases,fair in 7 cases,and poor outcome in 1 case,with the excellent and good rate of 93.33%.Whereas in group B,excellent was achieved in 49 cases,good in 53 cases,fair in 5 cases,poor in 4 cases,with the excellent and good rate was 89. 92%.There was no significant difference between the two groups. Conclusion The two methods can both obtain satisfactory outcome in lumbar spinal stenosis,but modified operation by microscope has smaller trauma, less bleeding,shorter hospitalization time,less cost,less complications,etc.

关 键 词：椎管狭窄 显微外科手术 外科手术 微创性 

分 类 号：R681.5[医药卫生—骨科学]