单通道、单侧双通道和双侧三通道脊柱内镜技术对腰椎管狭窄症的临床疗效比较  

Comparison of clinical efficacy of single channel,unilateral double channel and bilateral three channel spinal endoscopy in the treatment of lumbar spinal stenosis

作　　者：康立星[1] 杨素梅[2] 张鹏[1] 高娅妮[1] 杜伟亮 贾子超[1] 陈光[1] KANG Li-xing;YANG Su-mei;ZHANG Peng;GAO Ya-ni;DU Wei-liang;JIA Zi-chao;CHEN Guang(Department of OrthopedicsⅠ,Langfang People's Hospital,Langfang 065000,Hebei,China;Department of Obstetrics,Langfang People's Hospital,Langfang 065000,Hebei,China)

机构地区：[1]廊坊市人民医院骨一科,河北廊坊065000 [2]廊坊市人民医院产科,河北廊坊065000

出　　处：《川北医学院学报》2021年第10期1323-1328,共6页Journal of North Sichuan Medical College

基　　金：河北省廊坊市科学技术研究与发展计划项目(2020013108)。

摘　　要：目的:探讨单通道、单侧双通道和双侧三通道脊柱内镜技术对腰椎管狭窄症的临床疗效。方法:按照手术方式不同将150例腰椎管狭窄症患者分为单通道内镜组(行单通道内镜技术)、单侧双通道内镜组[行单侧双通道内镜技术(UBE)]及双侧三通道组(行双侧三通道技术),每组各50例。对三组患者手术情况、术前后日本骨科协会评分(JOA)、视觉模拟评分(VAS)、欧式功能障碍指数评分(ODI)、MOS 36项简表健康调查评分(SF-36)、术后疗效及并发症发生率进行比较。结果:三组患者术中出血量比较,差异无统计学意义(P>0.05);单通道内镜组的手术时间均长于其余两组(P<0.05),而其余两组手术时间比较,差异无统计学意义(P>0.05);双侧三通道组术后下床时间及住院时间均长于其余两组(P<0.05),而其余两组术后下床时间及住院时间比较,差异无统计学意义(P>0.05)。术后,三组JOA评分及生活质量评分均较术前升高,VAS评分、ODI评分均较术前降低(P<0.05);与单通道内镜组相比,单侧双通道内镜组及双侧三通道组JOA评分及生活质量评分升高,VAS评分、ODI评分降低(P<0.05);与单侧双通道内镜组相比,双侧三通道组JOA评分及生活质量评分升高,VAS评分、ODI评分降低(P<0.05)。术后,单通道内镜组与单侧双通道内镜组总优良率及并发症率比较,差异无统计学意义(P>0.05);双侧三通道组总优良率均高于其他两组,并发症总发生率均低于其他两组(P<0.05)。结论:与单通道内镜及UBE技术相比,虽然双侧三通道内镜术术后患者的住院时间长,但总体疗效好,更有助于改善患者的腰椎症状及生活质量,并发症风险低。Objective:To investigate the effects of single channel,unilateral double channel and bilateral three channel spinal endoscopy in the treatment of lumbar spinal stenosis.Methods:A total of 150 patients with lumbar spinal stenosis were selected as the research objects.All the patients were divided into a single-channel endoscopy group(50 patients received single-channel endoscopy)and a unilateral double-channel endoscopy group(50 patients received unilateral double-channel endoscopy),and bilateral three-channel group(bilateral three-channel technique,50 cases)according to different surgical methods.The operative situation,preoperative and postoperative Japanese Orthopaedic Association score(JOA),visual analogue score(VAS),European dysfunction index(ODI),MOS 36 Simplified Health Survey Score(SF-36),postoperative efficacy and incidence of complications in three groups were compared.Results:There was no significant difference in intraoperative blood loss among the three groups(P>0.05).The operation time of the single channel endoscopy group was longer than that of the other two groups(P<0.05),while there was no significant difference in the operation time between the other two groups(P>0.05).The postoperative time of getting out of bed and length of hospital stay in the bilateral three-channel group was longer than that in the other two groups(P<0.05),while there was no significant difference in the postoperative time of getting out of bed and length of hospital stay between the other two groups(P>0.05).After surgery,the JOA scores and quality of life scores of the three groups were higher than those before surgery,while VAS scores and ODI scores were lower than those before surgery(P<0.05).Compared with the single-channel endoscopy group,the JOA scores and quality of life scores of the unilateral dual-channel endoscopy group and the bilateral three-channel endoscopy group were increased,while the VAS scores and ODI scores were decreased(P<0.05).Compared with the unilateral dual-channel endoscopy group,the JOA scores

关 键 词：腰椎管狭窄症 单通道内镜技术 单侧双通道内镜技术 双侧三通道技术 疗效分析 生活质量 

分 类 号：R687.3[医药卫生—骨科学]