双通道脊柱内镜下单侧入路双侧椎管减压术治疗重度腰椎管狭窄症的疗效及术后并发症分析  

Analysis of efficacy and postoperative complications of unilateral biportal endoscopic unilateral laminectomy for bilateral decompression in treatment of severe lumbar spinal stenosis

作　　者：孙英杰 李龙 代益博 SUN Ying-jie;LI Long;DAI Yi-bo(Department of Extraskeletal SurgeryⅠ,Xuchang People's Hospital,Xuchang,Henan 461000,China)

机构地区：[1]许昌市人民医院骨外一科,河南许昌461000

出　　处：《医药论坛杂志》2025年第2期180-184,共5页Journal of Medical Forum

摘　　要：目的 比较后路椎间融合术(posterior lumbar interbody fusion,PLIF)和双通道脊柱内镜下单侧入路双侧椎管减压术(unilateral biportal endoscopy unilateral laminotomy for bilateral decompression,UBE-ULBD)在治疗重度腰椎管狭窄症中的疗效差异及对术后并发症的影响。方法 选取许昌市人民医院2021年1月—2022年6月重度腰椎管狭窄症手术患者102例作为研究对象,采用随机数字表法分为对照组和观察组。对照组患者采用PLIF治疗,观察组患者采用UBE-ULBD治疗。比较两组患者手术时间、术中出血量、术后引流量、输血例数、术后下地时间、术后出院时间、手术费用差异以及两组手术前后腰背部和下肢疼痛情况及肢体功能状况;并比较两组术后并发症情况。结果 观察组患者手术时间、术中出血量、术后引流量、输血例数、术后下地时间、术后出院时间、手术费用均低于对照组患者,差异有统计学意义(P<0.05);两组患者术前、术后1年腰疼视觉模拟评分法(visual analogue scale,VAS)评分和Oswestry功能障碍指数(Oswestry dysfunction index,ODI)评分、术后6个月ODI评分比较,差异无统计学意义(P>0.05),但观察组术后1 d、术后1个月、术后6个月腰疼VAS评分和术后1个月ODI评分优于对照组患者,差异有统计学意义(P<0.05);重复测量结果显示,两组间的腰疼VAS评分和ODI评分,差异有统计学意义(P<0.05);两组患者的腿疼VAS评分各时点比较以及重复测量除交互效应之外的方面,差异无统计学意义(P>0.05)。术后观察组患者并发症发生率为5.88%(3/51),对照组患者并发症发生率为13.73%(7/51),两组并发症发生率方面,差异无统计学意义(P>0.05)。结论 UBE-ULBD是一种微创手术,其治疗重度腰椎管狭窄症相较于PLIF对于患者的伤害更小,且术后短期恢复快,手术成本低。Objective To compare the efficacy differences and postoperative complications between posterior lumbar interbody fusion(PLIF) and unilateral biportal endoscopic unilateral laminectomy for bilateral decompression(UBE-ULBD) in the treatment of severe lumbar spinal stenosis.Methods Totally 102 cases with severe lumbar spinal stenosis who were operated in the Xuchang People's Hospital from January 2021 to June 2022 were selected as the study objects,and were divided into control groups and observation groups using the randam number table method.The patients in the control group were treated with PLIF,and the patients in the observation group were treated with UBE-ULBD.The operation time,intraoperative bleeding volume,postoperative drainage volume,number of blood transfusion cases,postoperative landing time,postoperative discharge time,surgical cost difference between the two groups,as well as the pain and limb function of the back and lower limbs before and after the operation were compared;the postoperative complications of the two groups were compared.Results The operation time,intraoperative bleeding volume,postoperative drainage volume,number of blood transfusion cases,postoperative landing time,postoperative discharge time and operation cost of patients in the observation group were lowers than those in the control group,and the differences were statistically significant(P<0.05);there was no significant difference between the two groups in visual analogue scale(VAS) score of low back pain and Oswestry dysfunction index(ODI) score and ODI score of 6 months after operation(P>0.05),but the VAS score of low back pain and ODI score of 1 day,1 month and 6 months after operation were better than those of the control group,and the differences were statistically significant(P<0.05);the repeated measurement results showed that there was a difference in VAS score and ODI score of low back pain between the two groups,and the differences was statistically significant(P<0.05);there was no significant difference in VAS score o

关 键 词：重度腰椎管狭窄症 后路椎间融合术 双通道脊柱内镜下单侧入路双侧椎管减压术 疼痛 肢体功能 

分 类 号：R687.3[医药卫生—骨科学]