显微镜微通道入路与后正中入路治疗腰椎间盘突出症的临床效果比较  

Clinical Effect Comparison of Microscopic Microchannel Approach and Posterior Median Approach in the Treatment of Lumbar Disc Herniation

作　　者：黄国青 肖银生 吴彭志 HUANG Guoqing;XIAO Yinsheng;WU Pengzhi(Department of Neurosurgery,Shaowu Municipal Hospital of Fujian Province,Shaowu,Fujian,354000,China)

机构地区：[1]福建省邵武市立医院神经外科,福建邵武354000

出　　处：《中外医疗》2024年第29期33-36,45,共5页China & Foreign Medical Treatment

基　　金：南平市自然科学基金联合资助项目(2019J46)。

摘　　要：目的分析临床中针对腰椎间盘突出症实施显微镜微通道入路和后正中入路的临床效果。方法随机选取2020年1月—2023年12月福建省邵武市立医院收治的100例腰椎间盘突出症患者为研究对象,按照不同手术方法分为对照组和观察组,每组50例。对照组采取后正中入路椎板开窗髓核摘除手术治疗,观察组采取显微镜微通道入路手术治疗,术后对患者进行为期3个月的跟踪随访,比较两组患者的疗效、围手术期指标、术后腰椎功能恢复情况、并发症发生情况、术后生活质量。结果观察组治疗总有效率为96.00%(48/50),高于对照组的80.00%(40/50),差异有统计学意义(χ^(2)=6.061,P=0.014)。观察组手术时间、术后下床时间、住院时间均短于对照组,切口长度小于对照组,术中出血量少于对照组,差异有统计学意义(P均<0.05)。术前,两组患者的腰椎功能障碍评分比较,差异无统计学意义(P>0.05);术后2周、术后4周、术后8周及术后12周,观察组腰椎功能评分均低于对照组,差异有统计学意义(P均<0.05)。观察组术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。术后,观察组生活质量评分高于对照组,差异有统计学意义(P<0.05)。结论临床治疗腰椎间盘突出症采用显微镜微通道入路术式效果更理想,有效促进患者腰椎功能的恢复,术后并发症较少。Objective To analyze the clinical effect of microscopic microchannel approach and posterior median ap⁃proach for lumbar disc herniation.Methods A total of 100 patients with lumbar disc herniation admitted to Shaowu Municipal Hospital of Fujian Province from January 2020 to December 2023 were randomly selected as the research objects.According to different surgical methods,they were divided into control group and observation group,with 50 cases in each group.The control group was treated with posterior median approach fenestration discectomy,and the observation group was treated with microscopic microchannel approach.The patients were followed up for 3 months af⁃ter operation.The curative effect,perioperative indexes,postoperative lumbar function recovery,complications and postoperative quality of life were compared between the two groups.Results The total effective rate of treatment in the observation group was 96.00%(48/50),which higher than that in the control group 80.00%(40/50),and the difference was statistically significant(χ^(2)=6.061,P=0.014).The operation time,postoperative ambulation time and hospitaliza⁃tion time of the observation group were shorter than those of the control group,the incision length was shorter than that of the control group,and the intraoperative blood loss was less than that of the control group,the differences were sta⁃tistically significant(all P<0.05).Before operation,there was no significant difference in lumbar dysfunction score be⁃tween the two groups(P>0.05);at 2 weeks,4 weeks,8 weeks and 12 weeks after operation,the lumbar function scores of the observation group were lower than those of the control group,and the differences were statistically significant(all P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).After operation,the quality of life score of the obser⁃vation group was higher than that of the control group,and the difference

关 键 词：显微镜微通道入路 后正中入路 腰椎间盘突出症 腰椎功能 

分 类 号：R687.3[医药卫生—骨科学]