单侧双通道内镜治疗重度腰椎管狭窄症的近期疗效分析  

Short-term efficacy of unilateral dual channel endoscopy in the treatment of severe lumbar spinal stenosis

作　　者：占允中[1] 杨帆 叶舟[1] 赵梓汝 刘华飞 吴以臣 黄伟铖 ZHAN Yunzhong;YANG Fan;YE Zhou;ZHAO Ziru;LIU Huafei;WU Yichen;HUANG Weicheng(Department of Spinal Surgery,Quzhou People's Hospital(Quzhou Hospital Affiliated to Wenzhou Medical University),Quzhou 324000,China;不详)

机构地区：[1]衢州市人民医院(温州医科大学附属衢州医院)脊柱外科,324000 [2]衢州市人民医院(温州医科大学附属衢州医院)高压氧科,324000

出　　处：《浙江医学》2024年第12期1300-1304,共5页Zhejiang Medical Journal

基　　金：衢州市第一批指导性科技攻关项目(2022033)。

摘　　要：目的探讨单侧双通道内镜治疗重度腰椎管狭窄症的近期疗效及对患者硬膜囊面积、功能恢复情况的影响。方法前瞻性选取2021年1月至2023年1月衢州市人民医院收治的重度腰椎管狭窄症患者60例为研究对象,采用随机数字表法分为观察组和对照组,各30例。观察组实施单侧双通道内镜技术,对照组实施传统腰椎后路椎板开窗减压术,比较两组患者手术效果、硬膜囊面积变化、功能恢复及并发症发生情况。结果观察组患者总优良率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05)。与术前比较,术后1个月两组患者硬膜囊面积均增大,且观察组大于对照组,差异均有统计学意义(均P<0.05)。与术前比较,术后3个月两组患者日本骨科协会腰痛评分均升高,Oswestry功能障碍指数均降低,且观察组均上述指标均优于对照组,差异均有统计学意义(均P<0.05)。观察组和对照组并发症发生率分别为10.00%和20.00%,两组比较差异无统计学意义(P>0.05)。结论单侧双通道内镜治疗重度腰椎管狭窄症近期疗效显著,可明显减轻患者术后疼痛程度,改善患者腰椎功能。Objective To explore the short-term efficacy of unilateral dual channel endoscopy in the treatment of severe lumbar spinal stenosis and its influence on the area of the dural sac and functional recovery of patients.Methods Sixty patients with severe lumbar spinal stenosis admitted to Quzhou People's Hospital from January 2021 to January 2023 were prospectively selected as the study objects,and patients were divided into observation group and control group by random number table method,with 30 cases in each group.The observation group was treated with unilateral dual channel endoscopy technology,while the control group was treated with traditional posterior lumbar laminectomy and fenestration decompression.The surgical effects,changes in the area of the dural sac,functional recovery,and the occurence of complications were compared between the two groups.Results The total excellent and good rate of patients in the observation group was 93.33%,which was higher than 73.33%in the control group(P<0.05).Compared with before the operation,the area of the dural sac in both groups increased 1 month after the operation,and the area in the observation group was larger than that in the control group(all P<0.05).Compared with before the operation,the Japanese Orthopedic Association(JOA)low back pain score increased and the Oswestry disability index(ODI)decreased in both groups 3 months after the operation,and the above indicators in the observation group were better than those in the control group(all P<0.05).The incidence of complications in the observation group and the control group was 10.00%and 20.00%,and there was no statistically significant difference between the two groups(P>0.05).Conclusion Unilateral dual channel endoscopy has a significant short-term efficacy in the treatment of severe lumbar spinal stenosis,which can significantly reduce the postoperative pain degree of patients and improve their lumbar spine function.

关 键 词：重度腰椎管狭窄症 单侧双通道内镜治疗 近期疗效 硬膜囊面积 功能恢复情况 

分 类 号：R687.3[医药卫生—骨科学]