大通道METRx下单侧入路双侧椎管减压术治疗退行性腰椎管狭窄症患者的效果  

Effects of bilateral spinal canal decompression via unilateral approach under large channel METRx in treatment of patients with Degenerative lumbar spinal stenosis

作　　者：牛洪彦 NIU Hongyan(Pain Department of Luoyang Yiluo Hospital,Luoyang 471000 Henan,China)

机构地区：[1]洛阳伊洛医院疼痛科,河南洛阳471000

出　　处：《中国民康医学》2024年第5期146-149,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察大通道椎间盘镜手术系统(METRx)下单侧入路双侧椎管减压术治疗退行性腰椎管狭窄症患者的效果。方法:选取2020年1月至2023年2月该院收治的130例退行性腰椎管狭窄症患者进行前瞻性研究,按随机数字表法将其分为对照组(n=65)和观察组(n=65)。对照组采用椎间孔镜下双侧入路双侧减压术治疗,观察组采用大通道METRx下单侧入路双侧椎管减压术治疗,比较两组围术期相关指标水平,手术前后腰椎功能[Oswestry功能障碍指数(ODI)]评分、疼痛程度[视觉模拟评分法(VAS)]评分、应激反应指标[去甲肾上腺素(NE)、多巴胺(DA)、5-羟色胺(5-HT)、P物质(SP)]水平和并发症发生率。结果:观察组术中出血量、透视次数均少于对照组,手术时间、住院时间均短于对照组,差异有统计学意义(P<0.05);术后3个月,两组ODI、VAS评分均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05);术后1周,两组NE、DA、5-HT、SP水平均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:大通道METRx下单侧入路双侧椎管减压术治疗退行性腰椎管狭窄症患者可降低围术期指标水平、应激反应指标水平、ODI评分和VAS评分,其效果优于椎间孔镜下双侧入路双侧减压术治疗。Objective:To observe effects of bilateral spinal canal decompression via unilateral approach under large channel micro endo disc system(METRx)in treatment of patients with Degenerative lumbar spinal stenosis.Methods:A prospective study was conducted on 130 patients with Degenerative lumbar spinal stenosis admitted to this hospital from January 2020 to February 2023.According to the random number table method,they were divided into control group(n=65)and observation group(n=65).The control group was treated with bilateral decompression via bilateral approach under intervertebral foramen mirror,while the observation group was treated with bilateral spinal canal decompression via unilateral approach under large channel METRx.The levels of perioperative related indicators,the lumbar function[Oswestry dysfunction index(ODI)]scores,the pain degree[visual analogue scale(VAS)]score,the stress response indicators[norepinephrine(NE),dopamine(DA),5-hydroxytryptamine(5-HT),substance P(SP)]levels before and after the surgery,and the incidence of complications were compared between the two groups.Results:The intraoperative blood loss and the fluoroscopy times in the observation group were less than those in the control group,the operation time and hospitalization time were shorter than those in the control group,and the differences were statistically significant(P<0.05).Three months after the surgery,the ODI and VAS scores of the two groups were lower than those before the surgery,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).One week after the surgery,the levels of NE,DA,5-HT and SP in the two groups were lower than those before the surgery,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusions:Bilateral spinal canal decompression

关 键 词：退行性腰椎管狭窄症 大通道 椎间盘镜手术系统 单侧入路双侧椎管减压术 腰椎功能 

分 类 号：R681.5[医药卫生—骨科学]