快速康复理念下微创经椎间孔入路腰椎椎间融合术治疗腰椎退变性疾病的临床研究  

Clinical study of the MIS-TLIF with the FTS in the treatment of lumbar degenerative diseases

作　　者：李文君[1] 王娜[1] 纪经涛[1] LI Wen-jun;WANG Na;JI Jing-tao(Spine Surgery of Tianjin Hospital,Tianjin 300211,China)

机构地区：[1]天津医院脊柱外科,天津300211

出　　处：《武警后勤学院学报（医学版）》2019年第10期40-44,共5页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】对比快速康复治疗方法与传统治疗方法在腰椎退变性疾病治疗中的疗效。【方法】2014年8月至2018年7月对21例腰椎单阶段退变性疾病患者进行治疗,快速康复组10例患者使用快速康复理念治疗方法[术前优化术前准备,术中应用微创经椎间孔入路腰椎椎间融合术(minimally invasive surgery transforaminal lumbar interbody fusion,MIS-TLIF)微创手术,术后优化饮食,伤口管理及术后康复等]。传统治疗方法组11例患者使用传统后路腰椎融合术(posterior lumbar interbody fusion,PLIF)治疗,并使用传统的术前术后准备方法。通过对手术时间、出血量、术后疼痛评分、术后康复等方面进行统计学分析,对比两组的治疗效果。【结果】全部病例随访3~26个月。两组术中出血量和术后引流量比较差异均具有统计学意义(P<0.01)。快速康复理念治疗组和传统治疗组术前与术后3个月视觉模拟评分法(visual analogue scale,VAS)和Oswestry功能障碍指数(oswestry disability index,ODI)评分比较差异具有统计学意义(P<0.01)。快速康复理念治疗组住院天数明显低于传统治疗组(P<0.01)。【结论】快速康复理念下的手术治疗对腰椎退变性疾病具有手术创伤小、术后康复快、术后并发症发病率低等优点,是一种高效、安全、有效的新方法。【Objective】To compare the therapeutic efficacy of FTS and traditional methods in the treatment of lumbar degenerative diseases.【Methods】From August 2014 to July 2018,21 patients with single-stage degenerative lumbar spine diseases were treated,and 10 patients in the ERAS group were treated with the EARS therapy(optimize preoperative preparation before surgery,apply MISTLIF during the operation,apply minimally invasive surgery,optimize the postoperative diet,apply wound management and postoperative rehabilitation,etc.).In the traditional treatment group,11 patients were treated with PLIF(posterior lumbar interbody fusion),and the traditional preoperative and postoperative preparation methods were used.By statistical analysis of the operation time,bleeding volume,postoperative pain score,postoperative rehabilitation,etc.,the treatment efficacy between the two groups was compared.【Results】All the cases were followed up for 3 to 26 months.In both groups,the intraoperative blood loss and postoperative drainage were significantly different(P<0.01).The preoperative and postoperative VAS score and ODI score were statistically significant in both groups(P<0.01).The period of hospital stay in the ERAS group was significantly longer than that in the traditional treatment group(P<0.01).【Conclusion】The surgical treatment in the EARS is of the advantages of less surgical trauma,quicker postoperative recovery,and lower incidence of postoperative complications for lumbar degenerative diseases.It is an efficient,safe and effective new method.

关 键 词：快速康复外科理念 微创经椎间孔入路腰椎椎间融合术 腰椎退变性疾病 

分 类 号：R473.6[医药卫生—护理学]