可扩张通道系统下MISS-TLIF治疗单节段Ⅰ~Ⅱ度DLS的疗效  

Efficacy of MISS-TLIF under expandable channel system in the treatment of single segment DLS with Ⅰ~Ⅱ degree

作　　者：杨贤玉 董胜利 刘帅 李来好 高振甫 YANG Xianyu;DONG Shengli;LIU Shuai;LI Laihao;GAO Zhenfu(General Hospital of Pingmei Shenma Group,Pingdingshan 467000,Henan)

机构地区：[1]平煤神马医疗集团总医院,河南平顶山467000

出　　处：《菏泽医学专科学校学报》2022年第1期40-43,66,共5页Journal of Heze Medical College

摘　　要：目的评价可扩张通道系统下微创经椎间孔椎体间融合术(MISS-TLIF)治疗单节段Ⅰ~Ⅱ度退行性腰椎滑脱症(DLS)的疗效。方法选取我院单节段Ⅰ~Ⅱ度DLS患者68例,随机抽签法分组,每组34例。对照组行传统开放手术,观察组行可扩张通道系统下MISS-TLIF,统计并对比两组术中透视数、手术时间、术后下地时间、术后引流量、术中失血量、并发症及术前、术后疼痛数字评价量表(NRS)评分、Oswestry功能障碍指数(ODI)评分、血清P物质(SP)、前列腺素2(PGE2)水平及血清去甲肾上腺素(NE)、皮质醇(Cor)水平。结果观察组术中透视数多于对照组,手术时间长于对照组,术后下地时间短于对照组,术后引流量、术中失血量少于对照组(P<0.05);术后3个月、6个月观察组NRS、ODI评分低于对照组(P<0.05);观察组术后3 d、7 d血清SP、PGE2水平低于对照组(P<0.05);术后3 d、5 d观察组血清Cor、NE水平低于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05)。结论可扩张通道系统下MISS-TLIF治疗单节段Ⅰ~Ⅱ度DLS患者增加术中透视次数,延长了手术时间,但缩短了术后下地时间,减少术中失血量、术后引流量,缓解术后疼痛度,增强腰椎功能,抑制疼痛因子与创伤应激。Objective To evaluate the efficacy of minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)under expandable channel system in the treatment of single segment degenerative lumbar spondylolisthesis(DLS)with I~II degree.Methods 68 patients with single segment DLS with I~II degree in our hospital were randomly divided into two groups,34 cases in each group.The control group was treated with traditional open surgery,and the observation group was treated with MIS-TLIF under expandable channel system.The intraoperative fluoroscopy number,operation time,postoperative time of getting out of bed,postoperative drainage volume,intraoperative bleeding volume,complications,preoperative,pain rating scale(NRS)score,Oswestry disability index(ODI)score,levels of substance P(SP),prostaglandin 2(PGE2),norepinephrine(NE)and cortisol(Cor)were compared between the two groups.Results The intraoperative fluoroscopy number in the observation group was more than that in the control group,the operation time was longer than that in the control group,the postoperative time of getting out of bed was shorter than that in the control group,the postoperative drainage volume and intraoperative bleeding volume were less than those in the control group(P<0.05).The NRS and ODI scores in the observation group 3 and 6 months after operation were lower than those in the control group (P <0.05). The levels of serum SP and PGE2 in the observation group 3 and 7 days after operation were lower than those in the control group (P <0.05). The levels of serum Cor and NE in the observation group 3 and 5 days after operation were lower than those in the control group (P <0.05). The incidence of complications in the observation group was significantly lower than that in the control group (P <0.05). Conclusion MIS-TLIF under expandable channel system in the treatment of DLS with I~II degree can increase the times of intraoperative fluoroscopy number, prolong the operation time, shorten the postoperative time, reduce bleeding volume and drainage volume

关 键 词：可扩张通道系统 微创经椎间孔椎体间融合术 退行性腰椎滑脱症 

分 类 号：R682.3[医药卫生—骨科学]