扩大开窗神经根管减压术对老年退行性腰椎管狭窄症患者神经系统功能和相关血清指标的影响  

The effect of extended fenestration and nerve root canal decompression on nervous system function and serum LEK,GFAP and PGE-2 in elderly patients with degenerative lumbar spinal stenosis

作　　者：宋建东 李停 徐红辉 李长文 

机构地区：[1]湖北省中西医结合医院骨科,湖北武汉430015

出　　处：《实用医院临床杂志》2017年第5期107-109,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨扩大开窗神经根管减压术对老年退行性腰椎管狭窄症患者神经系统功能和血清亮脑啡肽(LEK)、神经胶质纤维酸性蛋白(GFAP)、前列腺素E-2(PGE-2)的影响。方法选取2013年8月至2016年8月我院收治的40例老年退行性腰椎管狭窄症患者,按随机数字表法分为对照组(实施全椎板切除减压内固定术)及研究组(实施扩大开窗神经根管减压术)各43例,比较两组手术一般情况、术前术后血清LEK、GFAP、PGE-2变化、神经功能、腰椎改良JOA评分系统及并发症发生率。结果研究组手术时间、住院时间短于对照组,手术切口、出血量低于对照组(P<0.05)。术后两组血清LEK、ASIA神经功能评分较术前明显升高,GFAP、PGE-2、JOA评分明显降低,且研究组各项指标变化较对照组明显(P<0.05);术后研究组并发症总发生率低于对照组(P<0.05)。结论扩大开窗神经根管减压术治疗老年退行性腰椎管狭窄症患者时,通过有效调节患者血清LEK、GFAP、PGE-2表达,继而达到明显改善患者神经功能、腰椎功能及降低并发症发生率的目的。Objective To investigate the effect of extended fenestration and nerve root canal decompression on nervous system function and serum leu-enkephalin （LEK）, glial fibrillary acidic protein （GFAP） and prostaglandin E-2 （PGE-2） in elderly patients with degenerative lumbar spinal stenosis. Methods Forty elderly patients with degenerative lumbar spinal stenosis treated in our hospi- tal from August 2013 to August 2016 were selected as subjects. They were divided into control group treated by total laminectomy de- compression and internal fixation, and study group treated by extended fenestration and nerve root canal decompression ,20 cases in each group. The general condition of operation, changes of serum LEK, GFAP and PGE-2 before and after operation, neurological function, modified JOA score and the incidence of complications were compared between the two groups. Results The operation time, hospitali- zation time,incision and blood loss in the study group were significantly shorter, smaller or less than those in the control group （P 〈 0. 05 ）. After operation, the serum LEK and ASIA neurological function scores were increased significantly in both groups, while GFAP, PGE-2 and JOA scores were decreased significantly, and the changes were more significant in the study group than that in the control group （P 〈 0. 05 ）. The incidence of complications in the study group was significantly lower than that in the control group （P 〈.0. 05 ）. Conclusion The application of extended fenestration and nerve root canal decompression in the treatment of elderly patients with de- generative lumbar spinal canal stenosis can significantly improve neurological function and lumbar function as well as reduce the inci- dence of complications through the effective regulati6n of serum LEK, GFAP and PGE-2.

关 键 词：老年退行性腰椎管狭窄症 扩大开窗神经根管减压术 神经系统功能 

分 类 号：R681.5[医药卫生—骨科学]