根据退行性脊柱侧凸患者症状选择不同手术方案的临床研究  

Clinical Study of Choose Different Operation Plan According to the Symptoms of Degenerative Scoliosis

作　　者：卢海霖[1] 邑晓东[1] 王宇[1] 李宏[1] 刘洪[1] 

机构地区：[1]北京大学第一医院骨科,北京100034

出　　处：《现代生物医学进展》2016年第30期5851-5853,5857,共4页Progress in Modern Biomedicine

摘　　要：目的:探究根据退行性脊柱侧凸患者症状选择不同手术方案的治疗效果。方法:随机选取我院2007年9月到2015年10月收治的退行性脊柱侧凸患者124例,根据症状不同分A组和B组。A组62例患者腰背痛,接受长节段矫形内固定术;B组62例患者下肢症状明显,接受责任节段减压内固术。治疗期间记录两组手术时间、术中出血量、固定节段数及腰前凸角度,于治疗前、治疗后1个月以及末次随访时腰椎侧凸处的Cobb角,并采用视觉模拟评分法(VAS)和Oswestry功能障碍指数(ODI)评价患者疗效。结果:A组手术时间、出血量、固定节段数及腰前凸角度显著高于B组(P<0.05);治疗后和末次随访两组患者VAS评分、ODI指数及Cobb角均有明显好转(P<0.05),两组治疗后和末次随访之间的差异无统计学意义(P>0.05)。结论:退行性脊柱侧凸在治疗时需根据患者具体症状选择不同的手术方案,长节段矫形内固定术耗时长、术中出血量多,在治疗时应谨慎,预防相关并发症的发生。Objective： To explore the effect of choose different operation plan according to the symptoms of degenerative scoliosis. Methods： 124 cases of degenerative scoliosis patients were randomly selected in our hospital from September 2007 to October 2015, which were divided into A group and B group according to the symptoms. A group of 62 cases of patients with low back pain, accepted long segmental orthopedic fixation,B group of 62 patients with lower extremity symptoms, accept responsibility for the reduction of internal fixation. Recorded the operation time, bleeding volume, fixation segments and lumbar lordosis angle of two groups during the treatment, and the Cobb angle of lumbar scoliosis at before treatment, 1 months after the treatment and last follow-up, And the visual analogue scale （VAS） and Oswestry disability index （ODI） were used to evaluate the efficacy of the patients. Results： The operation time, bleeding volume, segmental fixation and lumbar lordosis angle of A group was obviously higher than that in B group （P〈0.05）; after treatment and at last follow-up, the VAS and ODI and Cobb angle of two groups were significantly improved （P〈0.05）, the difference between after treatment and last follow-up in two groups had no statistical significance （P〉0.05）. Conclusion： In the treatment of degenerative seoliosis patients with specific symptoms must be selected according to the different surgical options, time-consuming fixation over a long segment of orthopedic, blood loss and more caution in the treatment,prevention of related complications.

关 键 词：退行性脊柱侧凸 症状类型 长节段矫形内固定术 责任节段减压内固术 

分 类 号：R681[医药卫生—骨科学]