不同入路方式对单节段LDH患者手术疗效的影响  

Effect of Different Approaches on the Curative Effect of Single Level LDH Patients

作　　者：胡维俊 何俊洲 王宇龙 HU Weijun;HE Junzhou;WANG Yulong(Department of Spinal Surgery,Guihang Guiyang Hospital,Guiyang,Guizhou Province,550009 China)

机构地区：[1]贵航贵阳医院脊柱外科,贵州贵阳550009

出　　处：《中外医疗》2023年第29期56-59,共4页China & Foreign Medical Treatment

摘　　要：目的探讨不同入路方式对单节段腰椎间盘突出症(lumbar disc herniation,LDH)患者手术疗效的影响。方法回顾性分析2021年7月—2023年6月贵航贵阳医院收治的90例单节段LDH患者的临床资料,根据入路方式将患者分为A组(后路椎板间入路,n=45)与B组(侧后方椎间孔入路,n=45)。比较两组患者的手术疗效,以及术后恢复情况。结果A组治疗优良率为93.33%,低于B组的95.56%,差异无统计学意义(χ^(2)=0.212,P=0.645)。A组手术时间短于B组,C形臂X射线机照射次数少于B组,卧床时间稍长于B组,差异有统计学意义(P<0.05)。治疗后,两组腰椎功能及疼痛评分比较,差异无统计学意义(P>0.05)。结论单节段LDH患者行椎间孔镜手术治疗期间,不同入路方式不会显著影响患者腰椎功能的恢复效果以及疼痛改善情况,但椎板间入路的手术时间较短,术中透视次数相对较少,应根据患者临床条件,合理选择入路方式。Objective To investigate the effect of different approaches on the surgical outcomes of patients with singlesegment lumbar disc herniation(LDH).Methods The clinical data of 90 patients with single-segment LDH admitted to the Guihang Guiyang Hospital from July 2021 to June 2023 were retrospectively analyzed,and the patients were di⁃vided into group A(posterior interlaminar approach,n=45)and group B(lateral-posterior foraminal approach,n=45)according to the access method.The operative effect and postoperative recovery were compared between the two groups.Results The treatment excellence rate of group A was 93.33%,which was lower than 95.56%in group B,and the difference was not statistically significant(χ^(2)=0.212,P=0.645).The operation time of group A was shorter than that of group B,the number of times of irradiation by C-arm X-ray machine was less than that of group B,and the bedridden time was a little longer than that of group B,and the difference was statistically significant(P<0.05).After treat⁃ment,the lumbar spine function and pain scores of the two groups were compared,and the difference was not statisti⁃cally significant(P>0.05).Conclusion During the treatment of single-level LDH patients with foraminal endoscopic surgery,different approaches do not significantly affect the recovery of lumbar function and the improvement of pain.However,the operation time of interlaminar approach is short and the intraoperative fluoroscopy times are relatively small,so the approach should be reasonably selected according to the clinical conditions of patients.

关 键 词：腰椎间盘突出症 单节段 入路方式 手术时间 术中透视次数 

分 类 号：R687.3[医药卫生—骨科学]