椎间孔镜减压术治疗老年早期腰椎退行性滑脱症的临床研究  

Clinical study of endoscopic decompression of intervertebral foramen in the treatment of early degenerative lumbar spondylolisthesis in the elderly

作　　者：汪洋 李志虎 武林 袁冬梅 陈骥[1] WANG Yang;LI Zhihu;WU Lin;YUAN Dongmei;CHEN Ji(Department of Orthopaedics,Central District People′s Hospital of Leshan City,Leshan,Sichuan 614000,China)

机构地区：[1]四川省乐山市市中区人民医院骨科,四川乐山614000

出　　处：《现代医药卫生》2020年第8期1167-1170,共4页Journal of Modern Medicine & Health

摘　　要：目的 分析椎间孔镜减压术(EDIF)治疗老年早期腰椎退行性滑脱症(DLS)临床疗效。方法 于2015年1月至2018年12月,将该院收治的94例老年早期DLS患者随机分为EDIF组(47例)与对照组(47例)。对照组行开放手术,EDIF组行EDIF。比较切口长度、术中出血量、手术时间、术后住院时间等手术指标,以及术前、术后7d炎性因子[肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)],疼痛因子[去甲肾上腺素(NE)、P物质(SP)、5-羟色胺(5-HT)]水平,以及术前、术后6个月功能障碍情况。结果 EDIF组切口长度、术中出血量、手术时间、术后住院时间均小于对照组(P<0.05)。术后7d,EDIF组TNF-α、IL-6、IL-1β及NE、SP、5-HT水平均低于对照组(P<0.05)。术后6个月,Oswestry功能障碍指数及日本骨科协会评估治疗分数组间比较差异无统计学意义(P>0.05)。结论 EDIF治疗老年早期DLS可恢复腰椎序列及脊柱稳定性,改善腰椎功能,创伤小,恢复快,可抑制炎性反应,缓解患者疼痛。Objective To investigate the clinical application of endoscopic decompression of intervertebral foramen(EDIF)in the treatment of early degenerative lumbar spondylolisthesis(DLS)in the elderly.Methods From Jan.2015 to Dec.2018,94 elderly patients with early DLS,admitted to this hospital,were randomly divided into EDIF group(n=47)and control group(n=47).Open operation was given to patients in control group,and EDIF was given to patients in EDIF group.Incision length,intraoperative blood loss,operation time,postoperative hospital time,serum inflammatory factors,including tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1β(IL-1β),serum pain factors,including norepinephrine(NE),substance P(SP),5-hydroxytryptamine(5-HT),detected before and 7 days after operation,and dysfunction evaluation,performed before and 6 months after operation were compared.Results Incision length,intraoperative blood loss,operation time and postoperative hospital time in EDIF group were lower than control group(P<0.05).Seven days after operation,the levels of TNF-α,IL-6,IL-1β,NE,SP and 5-HT in EDIF group were lower than control group(P<0.05).Six months after operation,there was no difference of Oswestry disability index and Japanese Orthopaedic Association Scores between the two groups(P>0.05).Conclusion EDIF treatment of early DLS in the elderly could restore lumbar sequence and spinal stability,improve lumbar function,minimize trauma,promote recovery,inhibit inflammatory response,and relieve pain in patients.

关 键 词：椎间孔镜减压术 老年 腰椎退行性滑脱症 炎性因子 疼痛因子 

分 类 号：R68[医药卫生—骨科学]