基于CT影像学及创伤应激指标评价椎间孔镜技术治疗单节段腰椎椎管狭窄症的临床疗效  

Evaluation of the clinical effect of TESSYS technique in treating single-segment LSS based on CT imaging and traumatic stress indicators

作　　者：肖英博 崔涛 刘科举 李海芳[1] 苏启超[2] Xiao Yingbo;Cui Tao;Liu Keju;Li Haifang;Su Qichao(Department of Pain,The Third Hospital of Qinhuangdao,Qinghuangdao 066000,China;Department of Anesthesiology,The Third Hospital of Qinhuangdao,Qinghuangdao 066000,China)

机构地区：[1]秦皇岛市第三医院疼痛科,秦皇岛066000 [2]秦皇岛市第三医院麻醉科,秦皇岛066000

出　　处：《中国医学装备》2025年第1期41-46,共6页China Medical Equipment

基　　金：秦皇岛市科学技术研究与发展计划(202004A020)。

摘　　要：目的:基于CT影像学及创伤应激指标评价经皮椎间孔镜(TESSYS)技术对单节段腰椎椎管狭窄症(LSS)的临床疗效。方法:选取2019年6月至2021年6月秦皇岛市第三医院收治的112例单节段LSS患者,采用随机数表法将其分为观察组和对照组,每组56例。观察组采取TESSYS技术治疗,对照组采取椎间孔镜"广泛-简单-直接"技术(BEIS)治疗。比较两组术前和术后1周椎管面积、突出物侵占比的CT影像学指标,以及术前,术后1及3d时的乳酸脱氢酶(LDH)、肌红蛋白(MYO)及皮质醇(COR)等创伤应激指标,以及术后6个月的治疗优良率;比较两组患者Oswestry功能障碍指数(ODI)、视觉模拟量表(VAS)评分以及日本骨科协会评估量表(JOA)评分;比较两组术后6个月治疗优良率以及术后并发症情况。结果:观察组平均住院时间为(4.29±1.08)d、平均手术时间为(93.53±22.01)min,均短于对照组的(6.61±1.72)d和(112.29±26.68)min,术中出血量为(30.15±8.26)ml,少于对照组的(41.35±11.58)ml,两组比较差异有统计学意义(t=8.548、4.059、5.892,P<0.05);观察组术后1周ODI、VAS评分低于对照组,JOA评分高于对照组,两组比较差异有统计学意义(t=9.443、8.969、6.084,P<0.05),术后3个月ODI、VAS评分低于对照组,JOA评分高于对照组,两组比较差异有统计学意义(t=9.706、3.753、5.894,P<0.05);观察组治疗优良率为94.64%,高于对照组的80.36%,两组比较差异有统计学意义(t=5.225,P<0.05);术后1周观察组椎管面积较对照组大,突出物侵占比较对照组少,两组比较差异有统计学意义(t=3.404、5.578,P<0.05);术后1d观察组血清LDH、MYO及COR水平低于对照组,两组比较差异有统计学意义(t=7.570、9.687、5.242,P<0.05),术后3d观察组血清LDH、MYO及COR水平低于对照组,两组比较差异有统计学意义(t=6.856、9.729、2.744,P<0.05);两组并发症发生率比较差异无统计学意义(P>0.05)。结论:与BEIS技术比较,TESSYS技术治疗单节段LSS具有Objective:To evaluate the clinical effect of transforaminal endoscopic spine system(TESSYS)technique in treating single-level lumbar spinal stenosis(LSS)based on computed tomography(CT)imaging and traumatic stress indicators.Methods:A total of 112 patients with single-level LSS admitted to The Third Hospital of Qinhuangdao from June 2019 to June 2021 were selected,and they were divided into observation group and control group by random number table method,with 56 cases in each group.The observation group was treated with TESSYS technique,and the control group was treated with"broad easy immediate surgery(BEIS)"technique of intervertebral foramen scope.The indicators of CT imaging of spinal canal area and protrusion ratio,as well as traumatic stress indicators included lactate dehydrogenase(LDH),myoglobin(MYO)and cortisol(COR),of two groups were compared before and 1 week after surgery.Oswestry Disability Index(ODI),Visual Analogue Scale(VAS)score and Japanese Orthopaedic Association(JOA)Scores were compared between the two groups.Excellent rates of treatment and postoperative complications of two groups were compared at the 6 th month after surgery.Results:The average hospital stay and operation time of observation group were respectively(4.29±1.08)d and(93.53±22.01)min,which were significantly shorter than(6.61±1.72)d and(112.29±26.68)min of control group,and the intraoperative blood loss of observation group was(30.15±8.26)ml,which was shorter than that(41.35±11.58)ml of control group,and the differences of them between two groups(t=8.548,4.059,5.892,P<0.05),respectively.At the 1st week after surgery,the ODI and VAS scores of observation group were lower than those of control group,and the JOA score was higher than that of control group,and the differences of them between two groups were significant(t=9.443,t=8.969,6.084,P<0.05),respectively.At the 3rd month after surgery,the ODI and VAS scores of observation group were respectively lower than those of control group,and JOA score of observation group was

关 键 词：腰椎椎管狭窄症(LSS) 影像学 创伤应激 经皮椎间孔镜(TESSYS) 腰椎功能 

分 类 号：R816.8[医药卫生—放射医学]