单侧双通道脊柱内镜技术与经通道显微镜双侧减压技术治疗退行性腰椎管狭窄症的临床研究  

Clinical Study on the Treatment of Degenerative Lumbar Spinal Stenosis with Unilateral Biportal Endoscopy and Microscopic Bilateral Decompression

作　　者：尹小锋 官奕云 林斌珍 曹立颖[1] 钟南 吴清华 曾辉 YIN Xiaofeng;GUAN Yiyun;LIN Binzhen;CAO Liying;ZHONG Nan;WU Qinghua;ZENG Hui(The Second Hospital of Longyan City,Longyan 364000,China;不详)

机构地区：[1]龙岩市第二医院,福建龙岩364000

出　　处：《中外医学研究》2024年第32期49-53,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨单侧双通道脊柱内镜技术(unilateral biportal endoscopic,UBE)与经通道显微镜双侧减压技术(microscopic bilateral decompression,MBD)治疗退行性腰椎管狭窄症(degenerative lumbar spinal stenosis,DLSS)的效果。方法:选取2020年1月-2022年12月在龙岩市第二医院脊柱手足踝外科治疗的80例DLSS患者作为研究对象,通过信封法随机分为UBE组(n=40,采取UBE实施手术治疗)和MBD组(n=40,采取MBD实施手术治疗)。观察两组患者的手术情况(手术时长、术后下床活动及住院时间),评估腰及下肢视觉模拟评分法(visual analogue scale,VAS)评分、Oswestry功能障碍指数(Oswestry disability index,ODI)、基于改良MacNab标准的临床疗效,并统计术后并发症情况。结果:UBE组手术时间、术后下床活动时间及住院时间均显著短于MBD组,且术后并发症发生率显著低于MBD组,差异有统计学意义(P<0.05);术后1个月、3个月,两组腰及下肢VAS评分与ODI指数相比术前均显著降低,且UBE组明显低于MBD组,UBE组优良率明显高于MBD组,差异有统计学意义(P<0.05)。结论:相较于MBD,UBE用于DLSS患者手术治疗可以充分对神经减压,同时减少软组织及骨性结构破坏,降低手术风险,高效缓解腰及下肢疼痛,促进腰椎功能恢复。Objective:To investigate the therapeutic effects of unilateral biportal endoscopy(UBE)and microscopic bilateral decompression(MBD)on degenerative lumbar spinal stenosis(DLSS).Method:Eighty patients with DLSS who were treated in the Department of Spinal,Hands and Ankles Surgery of the Second Hospital of Longyan City from January 2020 to December 2022 were selected and randomly divided into UBE group(n=40,UBE was used during operation)and MBD group(n=40,MBD was used during operation)by the envelope method.Operation related indexes(operation time,postoperative off-bed activity and length of hospital stay)in the two groups were observed.The visual analogue scale(VAS)scores for the waist and lower limbs,Oswestry disability index(ODI),and clinical efficacy evaluated based on modified MacNab criteria were evaluated.Postoperative complications were recorded.Result:Operation time,postoperative ambulation time,hospital stay of UBE group were shorter than those of MBD group,and postoperative complication rate of UBE group was significantly lower than that of MBD group,the difference were statistically significant(P<0.05).At 1 month and 3 months after operation,visual analogue scale(VAS)scores of the waist and lower limbs and ODI scores of both groups were significantly lower than those before operation,UBE group had significantly better scores than MBD group,and the excellent and good rate in UBE group was significantly higher than that in MBD group,the difference were statistically significant(P<0.05).Conclusion:Compared to MBD,UBE used in operation for DLSS can achieve central spinal canal nerve,reduce soft tissue and bone structure damage,greatly reduce the risk of operation,efficiently relieve lumbar and lower limb pain,and promote lumbar function recovery.

关 键 词：单侧双通道脊柱内镜技术 经通道显微镜双侧减压技术 退行性腰椎管狭窄症 临床疗效 并发症 

分 类 号：R687.3[医药卫生—骨科学]