CAJ | 학술논문

目的：比较Wiltse入路与传统开放入路在单节段腰椎融合术中的应用效果。方法选取2012年12月~2013年12月本科收治的符合标准的经Wiltse入路行腰椎后路减压融合术的25例患者为观察组，经传统后路减压融合术的25例患者为对照组，比较两组的手术时间、术中出血量、术后引流时间，术后2周、3个月、6个月评定视觉模拟疼痛评分(VAS)及Oswestry功能指数评分，术后1、3、7 d检测两组的肌酸激酶水平。结果两组手术时间差异无统计学意义(P>0.05)；观察组术中出血量明显少于对照组，术后引流时间明显短于对照组，差异有统计学意义(P<0.05)。观察组术后各个随访时间点VAS及Oswestry功能指数评分明显低于对照组，差异有统计学意义(P<0.05)。术后1、3 d观察组肌酸激酶水平明显低于对照组，差异有统计学意义(P<0.05)；术后7 d两组肌酸激酶水平差异无统计学意义(P>0.05)。结论 Wiltse入路与传统入路相比具有出血量少、引流时间短、多裂肌损伤小及恢复快等优点。
목적：비교Wiltse입로여전통개방입로재단절단요추융합술중적응용효과。방법선취2012년12월~2013년12월본과수치적부합표준적경Wiltse입로행요추후로감압융합술적25례환자위관찰조，경전통후로감압융합술적25례환자위대조조，비교량조적수술시간、술중출혈량、술후인류시간，술후2주、3개월、6개월평정시각모의동통평분(VAS)급Oswestry공능지수평분，술후1、3、7 d검측량조적기산격매수평。결과량조수술시간차이무통계학의의(P>0.05)；관찰조술중출혈량명현소우대조조，술후인류시간명현단우대조조，차이유통계학의의(P<0.05)。관찰조술후각개수방시간점VAS급Oswestry공능지수평분명현저우대조조，차이유통계학의의(P<0.05)。술후1、3 d관찰조기산격매수평명현저우대조조，차이유통계학의의(P<0.05)；술후7 d량조기산격매수평차이무통계학의의(P>0.05)。결론 Wiltse입로여전통입로상비구유출혈량소、인류시간단、다렬기손상소급회복쾌등우점。
Objective To compare the effect of Wiltse approach and traditional approach in lumbar fusion surgery. Methods 25 patients underwent one-level instrumented posterior lumbar interbody fusion with Wiltse approach in our hospital from December 2012 to December 2013 were selected as observation group,and another 25 patients taken with traditional approach were selected as control group.The operation time,amount of bleeding,postoperative drainage time of two groups were compared;visual analog scale (VAS) and Oswestry index score after 2 weeks,3 months and 6 months treatment were assessed;serum level of Creatinine kinase after 1,3,7 days treatment were detected. Results There was no significant difference about operation time between the two groups (P>0.05);amount of bleeding in observation group were less than that of control group,postoperative drainage time was shorter than that of control group,the differences were significant (P<0.05).VAS and Oswestry index score of observation group after 2 weeks,3 months and 6 months treatment were lower than those of control group,the differences were significant (P<0.05).Creatinine kinase of observa-tion group after 1,3 days treatment were lower than those of control group,the difference was significant (P<0.05);but there was no significant difference after 7 days treatment (P>0.05). Conclusion Compared with traditional approach, Wiltse approach has more advantages in blood lose,duration of catheter drainage,paraspinal muscle protection and post-operative recovery.