骶棘肌复位缝合法与传统骶棘肌游离法在单纯椎板间隙开窗髓核摘除术中的应用  

The application of suture with sacrospinal muscle reposition and conventional suture with sacrospinal muscle floating in simple laminectomy gap discectomy

作　　者：赵志胜[1] 石胜强[1] 夏富华 

机构地区：[1]泰州市第三人民医院骨科,江苏泰州225321

出　　处：《临床和实验医学杂志》2015年第9期753-756,共4页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金资助项目(编号:30970835)

摘　　要：目的对比分析后路单纯椎板间隙开窗髓核摘除术中骶棘肌复位缝合法与传统骶棘肌游离法治疗腰椎间盘突出症的临床效果,探讨骶棘肌复位缝合法的应用价值。方法回顾性分析2009年6月至2013年7月单节段腰椎间盘突出症患者80例,按照治疗方式的不同分为观察组(行骶棘肌复位缝合法治疗)和对照组(行传统骶棘肌游离法治疗),比较两组术后引流量、并发症发生情况、术后住院天数,手术前后视觉模拟评分(VAS)和功能障碍评分(ODI),以及患者术后48 h血红蛋白丢失率。结果观察组、对照组术后引流量分别为(121.4±12.8)ml、(159.7±14.3)ml,血红蛋白丢失率分别为(1.4±0.6)%、(2.3±0.8)%,术后ODI评分分别为(11.6±7.3)分、(15.4±8.8)分,以上项目两组差异明显,均有统计学意义(P<0.05)。两组术后住院时间分别为(9.3±1.1)d、(9.4±1.3)d,两组术后VAS评分分别为(2.1±1.8)分、(2.7±1.9)分,以上项目两组比较差异均无统计学意义(P>0.05)。观察组并发症发生例数少于对照组,但差异无统计学意义(P>0.05)。结论骶棘肌复位缝合法具有术后引流量少、并发症发生率低、术后ODI评分值及术后48 h血红蛋白丢失率低等优点,是一种良好的手术方式,值得临床推广应用。Objective To compare the clinical efficacy of suture with sacrospinal muscle reposition and suture with sacrospinal muscle floating and evaluate the value of suture with sacrospinal muscle reposition for the treatment of lumbar disc herniation. Methods Eighty cases of lumbar disc herniation treated in our hospital from June 2009 to July 2013 were retrospective analyzed. They were divided into observation group and control group by different ways of treatment. The observation group received suture with sacrospinal muscle reposition treatment,the control group received suture with sacrospinal muscle floating treatment. Compare the efficacy differences between the two groups in postoperative drain-age,complications,postoperative hospital stay,visual analog scale（VAS）and functional disability scores（ODI）before and after surgery,and 48 h postoperative hemoglobin loss rate. Results The postoperative drainage in observation group and control group were 121. 4 ± 12. 8 ml,159. 7 ± 14. 3 ml,hemoglobin loss ratio were 1. 4 ± 0. 6% ,2. 3 ± 0. 8% ,ODI score after operation were 11. 6 ± 7. 3 points,15. 4 ± 8. 8 points,there were significant differences between the two groups in these parameters（all P 〈 0. 05）. The postoperative hospital stay in observation group and control group were 9. 3 ± 1. 1 d,9. 4 ± 1. 3 d,postoperative VAS scores were 2. 1 ± 1. 8 points,2. 7 ± 1. 9 points,the difference in the two param-eters were not statistically significant（all P 〉 0. 05）. Conclusion Suture with sacrospinal muscle reposition has less postoperative drainage,low complication rate,postoperative ODI scores and hemoglobin loss rate. It is a good surgical approach worthy of clinical use.

关 键 词：腰椎间盘突出症 髓核摘除 骶棘肌复位缝合 骶棘肌游离 

分 类 号：R687.3[医药卫生—骨科学]