CAJ | 학술논문

目的：观察改良显微镜下手术治疗腰椎管狭窄症的临床效果。方法将2008年2月~2013年2月入院治疗腰椎管狭窄症的239例患者,随机分为两组,A 组采用改良显微镜下手术,B 组采用传统开放手术,比较两者在手术失血、住院时间、医药费、并发症及疗效等方面的指标。结果 A、B 组各3例发生硬脊膜破裂,B 组4例术后腰椎不稳。术后无神经根损伤、感染等并发症。手术失血、住院时间、医药费比较差异具有统计学意义(P <0.001)。224例获得12个月以上随访,根据中华医学会腰背痛手术评定标准评定疗效,A 组优54例,良51例,可7例,差1例,优良率93.33%；B组优49例,良53例,可5例,差4例,优良率89.92%,两组之间差异无统计学意义(P >0.05)。结论两种方法疗效满意,但改良显微镜下手术具有创伤小、出血少、住院日短、医疗费用少、并发症少等优点。
목적：관찰개량현미경하수술치료요추관협착증적림상효과。방법장2008년2월~2013년2월입원치료요추관협착증적239례환자,수궤분위량조,A 조채용개량현미경하수술,B 조채용전통개방수술,비교량자재수술실혈、주원시간、의약비、병발증급료효등방면적지표。결과 A、B 조각3례발생경척막파렬,B 조4례술후요추불은。술후무신경근손상、감염등병발증。수술실혈、주원시간、의약비비교차이구유통계학의의(P <0.001)。224례획득12개월이상수방,근거중화의학회요배통수술평정표준평정료효,A 조우54례,량51례,가7례,차1례,우량솔93.33%；B조우49례,량53례,가5례,차4례,우량솔89.92%,량조지간차이무통계학의의(P >0.05)。결론량충방법료효만의,단개량현미경하수술구유창상소、출혈소、주원일단、의료비용소、병발증소등우점。
Objective To observe the efficacy of modified operation under microscope for lumbar spinal stenosis. Methods A tptal of 239 cases of patients with lumbar spinal canal stenosis cared at our hospital from February 2008 to February 2013 were randomly divided into two groups.Patients in group A were treated with modified operation under microscope,whereas patients in group B were treated with traditional open operation. The blood loss during the operation,hospitalization time,medical expenses,complications and curative efficacy were compared in the two groups. Results Endorachis rupture occurred in 3 cases of each group,4 cases in group B had lumbar spinal instability after the operation.There was no complication such as nerve root injury and infection in the two groups after the operation.Statistical differences in comparison of surgical blood loss,hospitalization time,medical expenses were obtained between the two groups (P <0.001).A total of 224 cases were followed up for more than 12 months.According to the evaluation criteria of surgical treatment of low back pain formulated by Chinese Medical Association,the assessment of the operation efficacy was done,results showed that in group A,excellent was achieved in 54 cases,good in 51 cases,fair in 7 cases,and poor outcome in 1 case,with the excellent and good rate of 93.33%.Whereas in group B,excellent was achieved in 49 cases,good in 53 cases,fair in 5 cases,poor in 4 cases,with the excellent and good rate was 89. 92%.There was no significant difference between the two groups. Conclusion The two methods can both obtain satisfactory outcome in lumbar spinal stenosis,but modified operation by microscope has smaller trauma, less bleeding,shorter hospitalization time,less cost,less complications,etc.