腰椎间盘突出症患者经改良后路腰椎椎体间融合术治疗疗效及并发症的影响因素  

The Effect of Modified Posterior Lumbar Interbody Fusion on Patients with Lumbar Disc Herniation and Influencing Factors of Complications

作　　者：杜卓姝 倪冬贝 张仑[1] DU Zhuoshu;NI Dongbei;ZHANG Lun(The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Urumqi 830054, China)

机构地区：[1]新疆医科大学第一附属医院,新疆乌鲁木齐830054

出　　处：《河北医学》2021年第4期556-562,共7页Hebei Medicine

基　　金：新疆维吾尔自治区自然科学基金,(编号:2019D01C299)。

摘　　要：目的:分析腰椎间盘突出症患者经改良后路腰椎椎体间融合术治疗疗效及并发症的多因素Logistic回归分析。方法:对2018年5月至2019年5月我院收治的243例腰椎间盘突出症患者的临床资料分析,采用随机数字表法进行简单随机分组,将予以后路腰椎椎体间融合手术治疗的患者设为对照组(n=121),将予以改良后路腰椎椎体间融合手术治疗的患者设为研究组(n=122)。比较两组患者临床疗效、并发症情况、不同时期功能恢复及疼痛情况。采用logistic回归分析影响腰椎间盘突出症患者经改良后路腰椎椎体间融合术术后并发症发生的危险因素。结果:研究组患者优良率明显高于对照组(97.80%vs 78.51%)(P<0.05);两组患者术后一个月、三个月及半年各时间点比较VAS评分及ODI评分逐渐降低,且研究组下降幅度更显著(P<0.05);两组短暂性神经功能缺失、硬脊膜撕裂、神经根损伤、感染等并发症发生情况比较未见明显差异(P>0.05);经非条件多因素Logistic回归模型分析可知,影响腰椎间盘突出症患者经改良后路腰椎椎体间融合术术后并发症发生的危险因素为:BMI≥25kg/m2、手术时间长、出血量多、术后引流量大及卧床时间长(P<0.05)。结论:予以经改良后路腰椎椎体间融合术治疗腰椎间盘突出症患者临床疗效佳,对术后疼痛及功能恢复效果显著;同时,术前控制患者BMI值,术中缩小手术时间、减少出血量,术后减少引流量及缩短卧床时间,可有效降低术后并发症发生。Objective:To analyze the therapeutic effect of modified posterior lumbar interbody fusion on patients with lumbar disc herniation and analyze the multivariate logistic regression of complications.Methods:The clinical data of 243 patients with lumbar disc herniation treated in our hospital from May 2018 to May 2019 were analyzed.Random number table method was used for simple random grouping.The patients treated with posterior lumbar interbody fusion were selected as the control group(n=121),and the patients treated with modified posterior lumbar interbody fusion were selected as the study group(n=122).The clinical efficacy,complications,functional recovery and pain in different periods were compared between the two groups.Logistic regression analysis was used to determine the risk factors of postoperative complications after modified posterior lumbar interbody fusion in patients with lumbar disc herniation.Results:The excellent and good rate of patients in the study group was significantly higher than that in the control group(97.80%vs 78.51%)(P<0.05).The VAS score and ODI score of the two groups one month,three months and half a year after surgery gradually decreased,and the decreasing of the study group was more significant(P<0.05).There was no significant difference in the incidence of complications such as transient neurological deficit,dural tear,nerve root injury,infection,etc.between the two groups(P>0.05).According to the analysis of unconditional multi-factor Logistic regression model,the risk factors affecting postoperative complications of patients with lumbar disc herniation after modified posterior lumbar interbody fusion are:BMI≥25kg/m2,long operation time,heavy bleeding,large postoperative drainage volume and long time in bed(P<0.05).Conclusion:Modified posterior lumbar interbody fusion in the treatment of patients with lumbar disc herniation has good clinical efficacy and significant effect on postoperative pain and functional recovery.At the same time,controlling the patient's BMI value before o

关 键 词：腰椎间盘突出症 经改良后路腰椎椎体间融合术 疗效 

分 类 号：R68[医药卫生—骨科学]