中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
17期
20-22
,共3页
张传开%赵日光%冯晖%孙义炎
張傳開%趙日光%馮暉%孫義炎
장전개%조일광%풍휘%손의염
脊椎前移%治疗结果%回归分析
脊椎前移%治療結果%迴歸分析
척추전이%치료결과%회귀분석
Spondylolisthesis%Treatment outcome%Regression analysis
目的 分析不同融合术式联合椎弓根固定治疗峡部裂性腰椎滑脱远期疗效的影响因素.方法 回顾性分析196例峡部裂性腰椎滑脱患者的手术资料及术后随访资料,选取年龄、性别、体质指数(BMI)、病程、术前日本矫形外科协会(JOA)评分、融合节段、融合术式、术后即刻恢复率、术后功能锻炼可能影响手术远期疗效的因素进行单因素分析和多因素回归分析.结果 随访5～9年,平均5.4年,疗效优良者163例,优良率达83.2％(163/196)；疗效欠佳者33例.术后未见硬脊膜撕裂、脑脊液漏、感染和内固定断裂等并发症.单因素分析表明,病程、BMI、术前JOA评分、术后功能锻炼对远期疗效有显著相关性(P＜0.05)；年龄、融合术式、融合节段、术后即刻恢复率、性别对远期疗效无显著相关性(P＞ 0.05).多因素回归分析结果表明,病程、术前JOA评分、术后功能锻炼是影响远期疗效的重要因素(OR=1.423、2.089、1.320,P=0.023、0.012、0.034).结论 病程、术前JOA评分、术后功能锻炼是影响峡部裂性腰椎滑脱手术患者远期疗效的重要因素.
目的 分析不同融閤術式聯閤椎弓根固定治療峽部裂性腰椎滑脫遠期療效的影響因素.方法 迴顧性分析196例峽部裂性腰椎滑脫患者的手術資料及術後隨訪資料,選取年齡、性彆、體質指數(BMI)、病程、術前日本矯形外科協會(JOA)評分、融閤節段、融閤術式、術後即刻恢複率、術後功能鍛煉可能影響手術遠期療效的因素進行單因素分析和多因素迴歸分析.結果 隨訪5～9年,平均5.4年,療效優良者163例,優良率達83.2％(163/196)；療效欠佳者33例.術後未見硬脊膜撕裂、腦脊液漏、感染和內固定斷裂等併髮癥.單因素分析錶明,病程、BMI、術前JOA評分、術後功能鍛煉對遠期療效有顯著相關性(P＜0.05)；年齡、融閤術式、融閤節段、術後即刻恢複率、性彆對遠期療效無顯著相關性(P＞ 0.05).多因素迴歸分析結果錶明,病程、術前JOA評分、術後功能鍛煉是影響遠期療效的重要因素(OR=1.423、2.089、1.320,P=0.023、0.012、0.034).結論 病程、術前JOA評分、術後功能鍛煉是影響峽部裂性腰椎滑脫手術患者遠期療效的重要因素.
목적 분석불동융합술식연합추궁근고정치료협부렬성요추활탈원기료효적영향인소.방법 회고성분석196례협부렬성요추활탈환자적수술자료급술후수방자료,선취년령、성별、체질지수(BMI)、병정、술전일본교형외과협회(JOA)평분、융합절단、융합술식、술후즉각회복솔、술후공능단련가능영향수술원기료효적인소진행단인소분석화다인소회귀분석.결과 수방5～9년,평균5.4년,료효우량자163례,우량솔체83.2％(163/196)；료효흠가자33례.술후미견경척막시렬、뇌척액루、감염화내고정단렬등병발증.단인소분석표명,병정、BMI、술전JOA평분、술후공능단련대원기료효유현저상관성(P＜0.05)；년령、융합술식、융합절단、술후즉각회복솔、성별대원기료효무현저상관성(P＞ 0.05).다인소회귀분석결과표명,병정、술전JOA평분、술후공능단련시영향원기료효적중요인소(OR=1.423、2.089、1.320,P=0.023、0.012、0.034).결론 병정、술전JOA평분、술후공능단련시영향협부렬성요추활탈수술환자원기료효적중요인소.
Objective To analyze the influence factors of long-term efficacy of different fusion combined with pedicle fixation for lumbar spondylolysis.Methods The surgical and postoperative follow-up data of 196 cases with lumbar spondylolysis were analyzed retrospectively.Age,gender,body mass index ( BMI ),disease course,preoperative Japanese orthopaedic association (JOA) score,fusion segments,fusion method,immediate postoperative recovery rate and postoperative functional exercise,which might affectlong-term operation efficacy,were selected to undergo single-factor analysis and multivariate regression analysis.Results All the patients were followed up for 5-9 years and 5.4 years for average,163 cases got excellent or good curative effect,the rate of excellent and good effect was 83.2％( 163/196);33 cases got poor efficacy.There was no cerebrospinal membrane tear,cerebrospinal fluid leakage,infection,fracture fixation and other complications happened after operation.Single-factor analysis showed that disease course,BMI,preoperative JOA score and postoperative functional exercise had obvious relation with long-term efficacy (P ＜ 0.05 ) ;while age,fusion method,fusion segments,immediate postoperative recovery rate and gender had no significant relation with long-term efficacy (P ＞ 0.05).Multivariate regression analysis showed that disease course,preoperative JOA score,postoperative functional exercise were important factors influencing long-term efficacy (OR =1.423,2.089,1.320,P=0.023,0.012,0.034).Conclusions Disease course,preoperative JOA score,postoperative functional exercise are important factors influencing long-term efficacy of surgery for patients with lumbar spondylolysis.
