Delta大通道脊柱内镜手术治疗腰椎管狭窄症的临床效果研究  

Clinical effect of Delta large-channel spinal endoscopic surgery in the treatment of lumbar spinal stenosis

作　　者：郭鑫[1] 宋向伟 佑路标 马犇 闫少杭 梁秋冬[1,2] 侯文根 GUO Xin;SONG Xiang-wei;YOU Lu-biao;MA Ben;YAN Shao-hang;LIANG Qiu-dong;HOU Wen-gen(Department of Orthopedics,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,Henan,CHINA;Xinxiang Key Laboratory of Spinal Infectious Diseases,Xinxiang 453100,Henan,CHINA)

机构地区：[1]新乡医学院第一附属医院骨科,河南新乡453100 [2]新乡市脊柱感染性疾病研究重点实验室,河南新乡453100

出　　处：《海南医学》2025年第7期967-970,共4页Hainan Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20210510)。

摘　　要：目的研究Delta大通道脊柱内镜手术治疗腰椎管狭窄症(LSS)的临床效果和安全性。方法选择2021年1月至2023年4月新乡医学院第一附属医院收治的105例LSS患者作为研究对象,按随机数表法分为对照组52例和研究组53例,对照组患者采用单侧双通道脊柱内镜技术(UBE)治疗,研究组患者采用Delta大通道脊柱内镜术治疗,术后均随访6个月。出院前,比较两组患者的手术相关指标(术中出血量、手术操作时间及住院时间);术前及术后6个月,比较两组患者的视觉模拟法(VAS)评分和Oswestry功能障碍指数问卷表(ODI)评分;术后6个月,比较两组患者的临床疗效;出院前,比较两组患者的并发症发生率。结果研究组患者的术中出血量、手术操作时间分别为(46.80±5.49)m L、(43.70±4.72)min,明显少(短)于对照组的(55.46±6.05)m L、(68.75±6.41)min,差异均有统计学意义(P<0.05),但两组患者的住院时间比较差异无统计学意义(P>0.05)。术前,两组患者的VAS评分和ODI评分比较差异均无统计学意义(P>0.05);术后6个月,两组患者的VAS评分及ODI评分与术前比较均降低,差异均有统计学意义(P<0.05);但两组患者术后6个月的VAS评分、ODI评分比较差异均无统计学意义(P>0.05)。术后6个月,研究组和对照组患者的治疗优良率分别为94.34%、92.31%,差异无统计学意义(P>0.05)。出院前,两组患者的并发症发生率分别为3.77%、7.69%,差异无统计学意义(P>0.05)。结论Delta大通道脊柱内镜手术及UBE均可有效减轻LSS患者疼痛,改善腰椎功能,但Delta大通道脊柱内镜术的操作更简便,在手术效率及减少术中出血量方面更具优势。Objective To investigate the clinical efficacy and safety of Delta large-channel spinal endoscopic surgery in the treatment of lumbar spinal stenosis(LSS).Methods A total of 105 LSS patients admitted to the First Affiliated Hospital of Xinxiang Medical University from January 2021 to April 2023 were selected as the study subjects.They were randomly divided into a control group(52 cases)and a study group(53 cases)using a random number table.Patients in the control group were treated with unilateral biportal endoscopy(UBE),while those in the study group were treated with Delta large-channel spinal endoscopic surgery.All patients were followed up for 6 months postoperatively.Before discharge,surgical-related indicators(intraoperative blood loss,operation time,and length of hospital stay)were compared between the two groups.Preoperatively and 6 months postoperatively,visual analog scale(VAS)scores and Oswestry Disability Index(ODI)scores were compared between the two groups.At 6 months postoperatively,clinical efficacy was compared between the two groups.Before discharge,the incidence of complications was compared between the two groups.Results The intraoperative blood loss and operation time in the study group were(46.80±5.49)mL and(43.70±4.72)min,respectively,which were significantly lower(shorter)than(55.46±6.05)mL and(68.75±6.41)min in the control group(P<0.05).However,there was no significant difference in the length of hospital stay between the two groups(P>0.05).Preoperatively,there were no significant differences in VAS and ODI scores between the two groups(P>0.05).At 6 months postoperatively,both groups showed significant reductions in VAS and ODI scores compared to preoperative values(P<0.05),but there were no significant differences in VAS and ODI scores between the two groups(P>0.05).At 6 months postoperatively,the excellent and good rates of treatment in the study group and control group were 94.34%and 92.31%,respectively,with no significant difference(P>0.05).Before discharge,the complication rates

关 键 词：腰椎管狭窄症 Delta大通道 单侧双通道 脊柱内镜 疗效 

分 类 号：R687.4[医药卫生—骨科学]