微创腰椎融合术对腰椎退行性疾病患者相关血清因子的影响  

Effect of minimally invasive surgery on the related serum factors in patients with lumbar degenerative disease

作　　者：孙义忠[1] 刘宝平[1] 范先东[1] 

机构地区：[1]中国人民解放军第251医院骨科,河北张家口075000

出　　处：《海南医学院学报》2016年第22期2742-2744,共3页Journal of Hainan Medical University

基　　金：河北省科技指标性课题(1021126D)~~

摘　　要：目的：探讨微创与传统经椎间孔腰椎椎体间融合术（TLIF）对腰椎退行性疾病患者相关血清因子的影响。方法：选取2014年5月~2016年5月我院收治的100例腰椎退行性疾病患者为研究对象,依据治疗术式不同分为对照组及观察组,分别行传统TLIF及微创TLIF（MIS-TLIF）;采集两组术前及术后2、4、8、24h外周静脉血,离心提取血清,采用ELISA法测定血清白细胞介素-6（IL-6）、白细胞介素-10（IL-10）水平;采集两组术前及术后1、3、5、7d外周静脉血,使用DGKC速率法检测肌酸激酶（CK）活性及融合率：根据Bridwell融合分级标准于术后6个月评估融合等级。结果：两组术后2、4、8、24h血清IL-6、IL-10水平高于术前（P〈0.05）,观察组术后各时间点血清IL-6、IL-10水平低于对照组（P〈0.05）;两组术后1、3、5、7d时CK活性高于术前（P〈0.05）,观察组术后各时间点CK活性低于对照组（P〈0.05）。结论：MIS-TLIF对机体组织损伤小,能有效减轻炎性反应,更好保留后柱稳定结构,与传统TLIF比较优势明显。Objective： To explore the effect of minimally invasive surgery and transforaminal lumbar interbody fusion （TLIF） on the related serum factors in patients with lumbar degenerative disease. Methods： A total of 100 patients with lumbar degenerative disease who were admitted in our hospital from May, 2014 to May, 2016 were included in the study and divided into the observation group and the control group according to different surgical methods. The patients in the observation group were given MIS-TLIF, while the patients in the control group were given the traditional TLIF. The peripheral venous blood be- fore operation, 2, 4, 8, and 24 h after operation in the two groups was collected, and centrifuged for the serum. ELISA was used to detect the serum IL-6 and IL-10 levels. The peripheral venous blood before operation, 1, 3, 5, and 7d after operation in the two groups was collected. DGKC velocity method was used to detect CK activity and fusion rate. The fusion grade was eval- uated 6 months after operation according to Bridwell fusion grading standard. Results： The serum IL-6 and IL-10 levels 2, 4, 8, and 24h after operation in the two groups were significantly elevated when compared with before operation （P〈0.05）, and the serum IL-6 and IL-10 levels at each timing point after operation in the observation group were significantly lower than those in the control group （P〈0.05）. CK activity 1, 3, 5, and 7d after operation in the two groups was significantly elevated when compared with before operation （P〈0.05）, and CK activity at each timing point after operation in the observation group was significantly lower than that in the control group （P〈0.05）. Conclusions： MIS-TLIF has a small damage on the tissues, can effectively alleviate the inflammatory reaction, and preferably retain the stable structure of posterior column, whose advantage is significantly superior to that by the traditional TLIF.

关 键 词：经椎间孔腰椎椎体间融合术(TLIF) MIS-TLIF 腰椎退行性疾病 组织创伤 血清因子 

分 类 号：R681.53[医药卫生—骨科学]