腰椎间盘突出症患者术后神经功能恢复不良的相关因素  

Related Factors of Poor Postoperative Neurological Recovery in Patients with Lumbar Disc Herniation

作　　者：孙秀钦[1] 马远[1] 李含[1] SUN Xiuqin;MA Yuan;LI Han(Department of Orthopedics,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院骨科,河南南阳473000

出　　处：《河南医学研究》2023年第2期292-295,共4页Henan Medical Research

摘　　要：目的观察腰椎间盘突出症患者术后神经功能恢复情况,并分析术后神经功能恢复不良的影响因素。方法采用前瞻性队列研究方法,对南阳市中心医院2018年2月至2021年12月收治的224例腰椎间盘突出症患者进行研究,所有患者均随访6个月,根据患者术后6个月神经功能恢复情况,分成不良组和良好组,同时设计患者一般资料表,将可能的影响因素纳入,分析影响腰椎间盘突出症患者术后神经功能恢复不良的相关因素。结果术后6个月期间,4例患者中途退出实验,最终有220例患者纳入此次研究,其中40例神经功能恢复不良,发生率为18.18%;不良组病程、椎间盘突出类型、合并神经根粘连、术前视觉模拟评分法(VAS)评分与良好组比较,差异有统计学意义(P<0.05);经logistic回归分析,结果显示,病程>6个月、突出型椎间盘、合并神经根粘连、术前VAS评分高均是腰椎间盘突出症患者术后神经功能恢复不良的影响因素(OR>1,P<0.05)。结论腰椎间盘突出症患者术后神经功能恢复不良可能与病程>6个月、突出型椎间盘、合并神经根粘连、术前VAS评分高等因素有关。Objective To observe the postoperative neurological recovery of patients with lumbar disc herniation and analyze the influencing factors of poor postoperative neurological recovery.Methods A prospective cohort study was conducted on 224 patients with lumbar disc herniation treated in Nanyang Central Hospital from February 2018 to December 2021.All patients were followed up for six months.According to the neurological recovery of patients 6 months after operation,they were divided into poor group and good group.At the same time,the baseline data table of patients was designed to include possible influencing factors,and the related factors affecting the poor neurological recovery of patients with lumbar disc herniation were analyzed.Results During 6 months after operation,4 patients withdrew from the experiment,and 220 patients were finally included in the study.Among them,40 patients had poor neurological recovery,with an incidence of 18.18%.There were statistically significant differences in the course of disease,type of intervertebral disc herniation,nerve root adhesion and preoperative visual analog scale(VAS)score between the poor group and the good group(P<0.05).Logistic regression analysis showed that the course of disease>6 months,herniated intervertebral disc,combined with nerve root adhesion and high preoperative VAS score were the influencing factors of poor postoperative neurological recovery in patients with lumbar disc herniation(OR>1,P<0.05).Conclusion The poor recovery of neurological function in patients with lumbar disc herniation after operation may be related to factors such as the course of disease>6 months,herniated intervertebral disc,combined with nerve root adhesion,and high preoperative VAS score.

关 键 词：腰椎间盘突出症 经皮椎间孔镜手术 神经功能 病程 神经根粘连 

分 类 号：R681.5[医药卫生—骨科学]