马尾神经综合征患者手术时机对预后的影响  

Effect of operation time on the results of lumbar disc herniation patients with cauda equina syndrome

作　　者：杨维新 张晓越 刘康 左可斌 李浩 YANG Wei-xin;ZHANG Xiao-yue;LIU Kang;ZUO Ke-bin;LI Hao(Department of Orthopedics,Qingyang People′s Hospital,Qingyang,Gansu 745000,China)

机构地区：[1]庆阳市人民医院骨一科,甘肃庆阳745000

出　　处：《颈腰痛杂志》2024年第3期404-407,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的 回顾性分析手术时机对腰椎间盘突出症(LDH)致马尾神经综合征(CES)患者手术结果的影响。方法 以2016年1月至2021年6月在该院接受手术治疗的47例LDH致CES患者作为研究对象。观察CES症状出现至手术时间对患者术后6个月时膀胱功能、肠道功能、运动能力和感觉功能等恢复情况的影响。结果 LDH致出现CES症状至手术完成时间<2 d、2~5 d、>5 d患者的膀胱功能和肠道功能差异均有统计学意义(P<0.05);随着出现CES症状至手术完成时间的延长,患者膀胱功能和肠道功能的恢复效果逐渐变差(P<0.05)。出现CES症状至手术完成时间<2 d、2~5 d、>5 d患者的肌肉力量和感觉功能恢复情况相比,差异均有统计学意义(P<0.05);随着出现CES症状至手术完成时间的延长,患者肌肉力量和感觉功能的恢复逐渐变差(P<0.05)。结论 LDH所致CES的早期减压与更好的预后相关,CES症状出现≥2 d手术可能导致永久性马尾神经功能障碍。Objective To investigate the influence of operation time on the results of lumbar disc herniation(LDH)patients with cauda equina syndrome(CES).Methods 47 patients with CES caused by LDH who received surgical treatment in our hospital from January 2016 to June 2021 were selected as study subjects.The recovery of bladder function,intestinal function,motor ability and sensory function of CES patients from different symptoms to the completion of surgery 6 months after surgery were observed.Results The time from symptom to operation completion was less than 2 days,2~5 days,and more than 5 days,and there was a statistically significant difference in bladder function and intestinal function(P<0.05).With the extension of the time from symptom to operation completion,the recovery effect of bladder function and intestinal function in patients became worse(P<0.05).The recovery of muscle strength and sensory function in patients with symptoms to the completion of surgery<2 days,2-5 days and>5 days were statistically significant(P<0.05).With the extension of the time from symptoms to the completion of surgery,the recovery of muscle strength and sensory function in patients became worse(P<0.05).Conclusion LDH induced early decompression of CES is associated with better prognosis,and delayed surgery may lead to potential persistent neurological dysfunction.

关 键 词：腰椎间盘突出症 马尾神经综合征 手术时机 功能恢复 

分 类 号：R681.5[医药卫生—骨科学]