单侧入路椎间孔镜双侧减压术与全椎板切除双侧减压术治疗中老年腰椎管狭窄症患者的临床效果对比  

Comparison of clinical effects of unilateral laminectomy for bilateral decompression versus total laminectomy for bilateral decompression for middle-aged and elderly patients with lumbar spinal stenosis

作　　者：李宗健 王斌 吾尔开希·托合提 丁江平 李双元 何斌 LI Zong-jian;WANG Bin;WUERKAIXI·Tuoheti(Bayingolin Mongolian Autonomous Prefecture People's Hospital,Korla 841000,China)

机构地区：[1]巴音郭楞蒙古自治州人民医院,841000

出　　处：《中国实用医药》2023年第14期55-57,共3页China Practical Medicine

摘　　要：目的探讨对中老年腰椎管狭窄症患者分别采用单侧入路椎间孔镜双侧减压术以及全椎板切除双侧减压术治疗的临床效果。方法60例中老年腰椎管狭窄症患者,以随机数字表法分为参照组和研究组,每组30例。参照组患者行全椎板切除双侧减压术治疗,研究组患者行单侧入路椎间孔镜双侧减压术治疗。对比两组患者手术前后视觉模拟评分法(VAS)评分、Oswestry功能障碍指数量表(ODI)评分及围术期指标(手术时间、切口长度、下床活动时间、术中出血量)、并发症发生情况。结果手术后1、3个月,研究组患者VAS评分、ODI评分均低于参照组,差异具有统计学意义(P<0.05)。研究组患者手术时间(109.39±11.15)min、下床活动时间(2.99±1.07)d、切口长度(3.06±0.63)cm短于参照组的(125.65±13.53)min、(5.05±1.09)d、(8.16±1.89)cm,术中出血量(128.55±13.49)ml少于参照组的(220.39±19.11)ml,差异具有统计学意义(P<0.05)。两组患者并发症发生率对比差异无统计学意义(P>0.05)。结论与全椎板切除双侧减压术比较,临床采用单侧入路椎间孔镜双侧减压术治疗中老年腰椎管狭窄症患者效果明显,手术创伤小,腰椎功能障碍以及疼痛程度得到显著缓解,且安全性较高,患者预后良好,值得推广应用。Objective To discuss the clinical effects of unilateral laminectomy for bilateral decompression versus total laminectomy for bilateral decompression for middle-aged and elderly patients with lumbar spinal stenosis.Methods A total of 60 middle-aged and elderly patients with lumbar spinal stenosis were divided into control group and research group according to the random numerical table,with 30 cases in each group.The control group underwent total laminectomy for bilateral decompression,while the research group underwent unilateral laminectomy for bilateral decompression.Both groups were compared in terms of visual analogue scale(VAS)score,Oswestry disability index scale(ODI)score,perioperative indexes(operative time,incision length,off-bed ambulation time,intraoperative blood loss),and the incidence of complications.Results At 1 and 3 months after surgery,the VAS scores and ODI scores of patients in the research group were lower than those of the reference group,and the differences were statistically significant(P<0.05).Patients in the research group had operative time of(109.39±11.15)min,off-bed ambulation time of(2.99±1.07)d,and incision length of(3.06±0.63)cm,which were shorter than those of(125.65±13.53)min,(5.05±1.09)d,and(8.16±1.89)cm in the reference group;the intraoperative blood loss of(128.55±13.49)ml in the research group was less than that of(220.39±19.11)ml in the reference group;the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Compared with total laminectomy for bilateral decompression,unilateral laminectomy for bilateral decompression in the treatment of middle-aged and elderly patients with lumbar spinal stenosis has more obvious effect,with less surgical trauma,significant relief of lumbar spine dysfunction and pain level,and higher safety and good patient prognosis,which is worth promoting.

关 键 词：单侧入路椎间孔镜双侧减压术 全椎板切除双侧减压术 中老年腰椎管狭窄症 效果 

分 类 号：R687.3[医药卫生—骨科学]