择期和急诊手术治疗寰枢椎节段椎管内占位性病变的疗效比较  

Analysis and comparison of curative effects of elective operation and emergency operation in treating atlantoaxial vertebral segmental spinal canal space-occupying lesions

作　　者：曹广如[1] 廖文波[1] 王霞[1] 蔡玉强[1] 王翀[1] 陈琦[1] 

机构地区：[1]遵义医学院附属医院脊柱外科,563003

出　　处：《重庆医学》2017年第25期3532-3535,共4页Chongqing medicine

摘　　要：目的比较择期和急诊行寰枢椎节段椎管内占位性病变手术的疗效。方法选取2010年5月至2015年4月在该院接受治疗的寰枢椎节段椎管内占位性病变患者32例,将患者分为急诊手术组(A组)14例和择期手术组(B组)18例。比较两组患者手术时间、术中出血量、JOA评分、ODI指数及VAS评分、术后影像学(MRI)改变情况和两组患者对疗效的满意度。结果术后A组患者的JOA评分[(25.23±4.47)分]高于B组[(22.10±3.56)分],差异有统计学意义(P<0.05)。两组患者的ODI指数及VAS评分都有所下降,ODI指数A组(18.56±3.10)分,B组(21.56±4.37)分、VAS评分A组(1.89±0.53)分,B组(3.16±0.89)分,两组ODI指数比较差异有统计学意义(P<0.05);两组VAS评分比较差异有统计学意义(P<0.05)。两组患者术前及术后1个月时脊髓功能分级(Frankel分级)比较,差异均无统计学意义(P>0.05)。A组手术时间[(120.23±9.02)min]与B组[(126.25±12.12)min]相比差异无统计学意义(P>0.05);A组患者的术中出血量[(211.26±12.25)mL]与B组[(220.43±17.58)mL]相比差异无统计学意义(P>0.05)。治疗后1个月A组患者的满意度(92.56%)高于B组患者(72.22%),差异有统计学意义(P<0.05)。结论急诊行寰枢椎节段椎管内占位性病变手术,能有效提高治疗效果,并且治疗后患者的满意度比较高,值得推广使用。Objective To compare and explore the curative effects of elective operation and emergency operation in treating atlantoaxial vertebral segmental spinal canal space-occupying lesions. Methods Thirty-two patients suffering from atlanto-axial ver- tebral segmental spinal canal space-occupying lesions treated in our hospital from May 2010 to April 2015 were selected and divided into the emergency operation group （group A,n= 14） and elective operation group （group B,n= 18）. The emergency and elective operations were adopted respectively. Then the operation time,intraoperative blood loss,JOA score, ODI index, VAS score, postop- erative imaging（MRI） and effect satisfaction degree were compared between the two groups. Results After treatment, the JOA score in the group A was （25.23±4.47） points,which was higher than （22.10±3.56） points in the group B,and the difference was statistically significant （t=3.67 ,P〈0.05）. The ODI index and VAS score of the two groups all were decreased. The ODI index in the group A was （18.56±3.10） points,which in the group B was （21.56±4.37） points,and there was statistically significant difference between the two groups （t = 3.76, P〈0. 05）. The VAS score in the group A was （1.89± 0.53）points, which in the group B was （3.16±0.89） points, the difference was statistically significant between the two groups （t = 3.76, P〉 0.05）. Before surgery and at postoperative 1 month,the spinal cord function classification（Frankel grade） of the two groups had no statistically significant difference between the two groups （Z= -0.18, P = 0.85 〉 0.05, Z= -0. 52, P = 0.60 〉 0.05）. The operation time had no statistical difference between the group A and B[-（ 120.23 ± 9.02）min vs. （126.25±12.12） min, P〉 0.05 ]. The intraoperative bleeding volume had had no statistical difference between the group A and B [ （211.26 ± 12.25）mL vs. （220.43± 17.58）mL, P〉 0.05]. After one month of treatment, the satisfaction degree in the gr

关 键 词：颈椎病 急诊手术 寰枢椎节段 椎管内 占位性病变. 

分 类 号：R687.3[医药卫生—骨科学]