椎间孔镜治疗老年腰椎管狭窄症早期临床疗效分析  

Early Clinical Effect Analysis of Intervertebral Foramen in the Treatment of Elderly Patients with Lumbar Spinal Stenosis

作　　者：丁华[1] 袁即山[1] 汪雷[1] 蒋勤益 徐勇 周辉辉[1] DING Hua;YUAN Ji-shan;WANG Lei;JIANG Qin-yi;XU Yong;ZHOU Hui-hui(Affiliated People's Hospital of Jiangsu University,Zhenjiang,Jiangsu Province,212002 China)

机构地区：[1]江苏大学附属人民医院

出　　处：《系统医学》2019年第23期4-7,共4页Systems Medicine

摘　　要：目的探讨分析椎间孔镜治疗老年腰椎管狭窄症的早期临床疗效。方法选取2016年5月—2019年2月在该院接受治疗的60例老年腰椎狭窄症患者作为研究对象,根据手术方式的不同将其分为对照组和研究组,各30例。对照组患者接受传统手术治疗,研究组患者接受经皮椎间孔镜手术治疗。比较两组患者的围术期指标,手术前后腰部视觉模拟疼痛评分(VAS)、腿部VAS评分、Oswestry功能障碍指数(ODI评分)及临床疗效。结果研究组手术时间、住院时间均明显短于对照组,术中出血量明显少于对照组,其术后24、48、72、96 h的手术切口VAS评分均显著小于对照组,差异有统计学意义(P<0.05)。两组患者术后腰部VAS评分、腿部VAS评分和ODI评分较术前均明显降低,且术后1 d、术后3个月、术后6个月时的研究组腰部VAS评分、腿部VAS评分和ODI评分均明显小于对照组,差异有统计学意义(P<0.05)。术后6个月采用改良MacNab评价临床疗效,对照组为70.0%,研究组为93.3%,研究组显著高于对照组,差异有统计学意义(χ^2=5.445,P=0.020<0.05)。结论经皮椎间孔镜技术治疗老年腰椎管狭窄症的早期临床疗效确切,其能达到彻底减压和松解恻隐窝处神经根的目的,同时不会对脊柱稳定性结构造成较大破坏,而且手术损伤小,患者术后恢复更快,值得临床推广应用。Objective To investigate the early clinical efficacy of intervertebral foramen in the treatment of elderly patients with lumbar spinal stenosis.Methods 60 elderly patients with lumbar stenosis who were treated in the hospital from May 2015 to February 2019 were enrolled in the study.According to different surgical methods,they were divided into control group and study group,30 cases each.Patients in the control group underwent conventional surgery,and patients in the study group underwent percutaneous transforaminal surgery.The perioperative parameters of the two groups were compared.The lumbar visual analog pain score(VAS),the leg VAS score,the Oswestry dysfunction index(ODI score)and clinical efficacy were compared before and after surgery.Results The operation time and hospitalization time of the study group were significantly shorter than that of the control group.The intraoperative blood loss was significantly less than that of the control group.The VAS scores of the surgical incision at 24,48,72 and 96 h after operation were significantly lower than those of the control group,the difference was statistically significant(P<0.05).The waist VAS score,leg VAS score and ODI score of the two groups were significantly lower than those before surgery,and the waist VAS score and leg VAS of the study group were 1 day,3 months after surgery and 6 months after surgery,and ODI scores were significantly lower than the control group(P<0.05).The clinical efficacy was evaluated by modified MacNab 6 months after surgery.The control group was 70.0%,and the study group was 93.3%.The study group was significantly higher than the control group,the difference was statistically significant(χ^2=5.445,P=0.020<0.05).Conclusion Percutaneous transforaminal technique is effective in the early stage of treatment of lumbar spinal stenosis in the elderly.It can achieve the purpose of completely decompressing and releasing the nerve root at the crypt,and does not cause great damage to the stability structure of the spine.Moreover,the surgi

关 键 词：腰椎管狭窄症 老年 经皮椎间孔镜技术 微创手术 临床疗效 

分 类 号：R687.3[医药卫生—骨科学]