流体明胶在单侧双通道脊柱内镜治疗腰椎退变性疾病中的应用  

Application of fluid gelatin in unilateral biportal endoscopic for lumbar degenerative diseases

作　　者：金凤 刘平平 李锦军[1] 费琦[1] 孟海[1] JIN Feng;LIU Ping-ping;LI Jin-jun(Department of Orthopedics,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院骨科,北京100050

出　　处：《临床和实验医学杂志》2024年第9期960-963,共4页Journal of Clinical and Experimental Medicine

基　　金：北京市卫生系统高层次卫生技术人才培养计划(编号:2015-3-009)。

摘　　要：目的探讨流体明胶应用于单侧双通道内镜治疗腰椎退行性疾病中的有效性及安全性。方法选取2020年1月至2022年6月在首都医科大学附属北京友谊医院骨科行单侧双通道内镜的腰椎椎间盘退变性疾病患者共89例进行回顾性分析。根据术中是否应用流体明胶分为试验组(使用流体明胶,n=40)和对照组(n=49)。所有患者均接受至少3个月随访,比较手术前和手术后3 d、1个月、3个月的腰腿部疼痛[视觉模拟评分法(VAS)]评分和Oswestry功能障碍指数(ODI)。手术后3个月,比较两组临床疗效、术后引流量、凝血功能以及术后并发症发生情况等。结果所有患者均顺利完成手术并进行随访。手术后3 d、1个月、3个月,两组腰腿部VAS评分和ODI均较手术前明显改善,差异均有统计学意义(P<0.05),但两组间腰腿部VAS评分和ODI比较,差异均无统计学意义(P>0.05)。手术后3个月,Fischgrund标准评价结果显示,试验组优良率为90.0%,对照组优良率为85.7%,两组比较差异无统计学意义(P>0.05)。试验组术后引流量为(15.23±13.46)mL,明显少于对照组[(28.69±29.68)mL],差异有统计学意义(P<0.05)。两组手术前、手术后凝血指标比较,差异均无统计学意义(P>0.05)。试验组发生并发症2例(5.0%),对照组发生并发症2例(4.1%),两组并发症发生率比较,差异无统计学意义(P>0.05)。结论流体明胶应用于单侧双通道内镜治疗腰椎退行性疾病中,临床疗效确切,可以显著降低术后引流量,且不影响凝血功能,不增加并发症发生率,安全性高。Objective To evaluate the effect and safety of fluid gelatin in unilateral biportal endoscopic for lumbar degenerative diseases.Methods A total of 89 consecutive patients with lumbar degenerative diseases were treated by unilateral biportal endoscopic in Beijing Friendship Hospital,Capital Medical University from January 2020 to June 2022 were etrospcctive analyzed.According to whether fluid gelatin was used during surgery,the patients were divided into the experimental group(using fluid gelatin,n=40)and the control group(not using fluid gelatin,n=49).The back and leg pain[visual analog scale(VAS)]score,oswestry disabillty index(ODI)before operation,3 days,1 month,and 3 months after operation were compared;the clinical outcomes,postoperative drainage volume and coagulation function,and surgical complications were compared between the two groups.Results At 3 days,1 month,and 3 months after operation,the back and leg VAS scores,and ODI in two groups showed significant improvement compared to before operation,the differences were statistically significant(P<0.05).However,there were no statistically significant differences in back and leg VAS scores and ODI between the two groups(P>0.05).The results of Fischgrund evaluation criteria at 3 month after operation showed that the excellent and good rate was 90.0%in the experimental group and 85.7%in the control group,there was no statistically significant difference(P>0.05).The postoperative drainage volume in experimental group was(15.23±13.46 mL),which was significantly lower than that in the control group[(28.69±29.68)mL],the difference was statistically significant(P<0.05).There were no statistically significant differences in coagulation indicators between the two groups before and after operation(P>0.05).There were 2 cases(5.0%)of complications in the experimental group and 2 cases(4.1%)in the control group.There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion The application of fluid gelatin

关 键 词：腰椎 单侧双通道内镜技术 退行性疾病 流体明胶 术后引流量 

分 类 号：R687.3[医药卫生—骨科学]