单纯减压和减压内固定治疗退行性腰椎管狭窄症术后近期效果的比较  

Contrast of short-term effect on simple decompression therapy and de-compression with fixation therapy in degenerative lumbar spinal stenosis

作　　者：杨勇[1] 刘刚[1] 苏义拉图[1] 

机构地区：[1]内蒙古医科大学附属医院骨科,内蒙古呼和浩特010050

出　　处：《中国医药导报》2015年第15期84-87,共4页China Medical Herald

基　　金：内蒙古自治区卫生和计划生育委员会科研立项(201301049)

摘　　要：目的：比较单纯减压治疗和减压内固定融合术治疗退行性腰椎管狭窄症术后近期效果。方法选择2010年6月~2014年1月内蒙古医科大学附属医院收治的退行性腰椎管狭窄症患者48例，按照治疗方式分为对照组（22例）与观察组（26例），对照组患者实施单纯减压治疗，观察组患者实施减压联合融合内固定术治疗，比较两组手术指标，治疗前、后日本骨科协会评估治疗分数（JOA）评分、视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）。结果对照组手术时间和术中出血量[（92.39±15.49）min、（138.83±21.17）mL]少于观察组[（131.49±21.54）min、（277.38±34.19）mL]，差异有高度统计学意义（P〈0.01）。观察组术前JOA评分、术后JOA评分、优良率分别为（4.19±0.85）分、（20.43±3.57）分、80.77%，与对照组比较[（4.64±1.02）分、（21.08±4.33）分、81.82%]，差异无统计学意义（P〉0.05）。观察组术后VAS评分、ODI均低于术前，差异有统计学意义（P〈0.05）；且观察组术后低于对照组[（1.41±0.37）分、（16.68±3.55）%比（3.38±0.39）分、（26.39±4.05）%]，差异有统计学意义（P〈0.05）。结论单纯减压治疗和减压内固定融合术治疗退行性腰椎管狭窄症近期疗效相近，单纯减压治疗创伤更小，减压内固定融合术治疗利于改善患者疼痛症状及生活质量。Objective To compare the short-term effect on simple decompression therapy and decompression with fixa-tion therapy in degenerative lumbar spinal stenosis, and provide a reference for clinical treatment. Methods From June 2010 to January 2014, in Affiliated Hospital of Inner Mongolia Medical University, 48 patients with degenerative lum-bar spinal stenosis were selected and divided into control group （22 cases） and observation group （26 cases）, accord-ing to the treatment, the control group were given simple decompression therapy, and observation group were given de-compression with fixation therapy. The Operation indicator, JOA score, leg pain VAS score, ODI before and after the treatment in two groups were compared. Results Operation time and blood loss [（92.39±15.49） min, （138.83±21.17） mL] in control group were less than those in observation group [（131.49±21.54） min, （277.38±34.19） mL], the differences were statistically significant （P〈0.01）. The preoperative JOA score, postoperative JOA score, excellent rates in observation group [（4.19±0.85） score, （20.43±3.57） score, 80.77%] were compared with those in control group [（4.64±1.02） score, （21.08±4.33） score, 81.82%], the differences were not statistically significant （P〈 0.05）. The postoperative VAS and ODI were less than preoperative, the differences were statistically significant （P〈 0.05）, and postoperative VAS and ODI in control group were less than those in observation group [（1.41±0.37） score, （16.68±3.55）% vs （3.38±0.39） score, （26.39±4.05）%], the differences were statistically significant （P〈 0.05）. Conclusion Simple decompression therapy and decompression with fixation therapy has the similar clinical effect of degenerative lumbar spinal stenosis. And simple decompression therapy has less truma, but decompression with fixation therapy is helpful to improve pain performance and life quality.

关 键 词：退行性改变 腰椎管狭窄症 减压 内固定 

分 类 号：R687.3[医药卫生—骨科学]