CAJ | 학술논문

目的：观察后路椎间盘镜（M ED ）治疗退变性椎管狭窄的临床疗效。方法选取2011年6月至2013年6月该院收治的126例患者作为研究对象，将患者分为两组，观察组采取M ED手术，对照组采取开放手术。观察两组患者的手术时间、术中出血量、术后住院时间和术后恢复时间，并将两组患者手术疗效进行比较，记录术后3个月和术后1年的间歇性跛行时间和Oswestry功能障碍指数（ODI）评分。结果观察组患者的手术时间、术后住院时间和术后恢复时间短于对照组，术中出血少，两组患者之间差异有统计学意义（P＜0．05）。观察组患者术后未发生脊柱侧凸和腰椎不稳，对照组术后2例患者发生脊柱侧突，两组患者术后并发症发生率差异无统计学意义（P＞0．05）。观察组优良率88．89％，对照组优良率85．71％，两组患者的手术疗效差异有统计学意义（ P＜0．05）。两组患者术后3个月的间歇性跛行时间和ODI评分差异有统计学意义（P＜0．05），术后1年的间歇性跛行时间和ODI评分差异无统计学意义（P＞0．05）。结论 MED的应用可以有效解除硬膜囊和神经根的压迫，缩短患者的恢复时间，从而一定程度上减少患者住院的费用，值得在临床上应用。
목적：관찰후로추간반경（M ED ）치료퇴변성추관협착적림상료효。방법선취2011년6월지2013년6월해원수치적126례환자작위연구대상，장환자분위량조，관찰조채취M ED수술，대조조채취개방수술。관찰량조환자적수술시간、술중출혈량、술후주원시간화술후회복시간，병장량조환자수술료효진행비교，기록술후3개월화술후1년적간헐성파행시간화Oswestry공능장애지수（ODI）평분。결과관찰조환자적수술시간、술후주원시간화술후회복시간단우대조조，술중출혈소，량조환자지간차이유통계학의의（P＜0．05）。관찰조환자술후미발생척주측철화요추불은，대조조술후2례환자발생척주측돌，량조환자술후병발증발생솔차이무통계학의의（P＞0．05）。관찰조우량솔88．89％，대조조우량솔85．71％，량조환자적수술료효차이유통계학의의（ P＜0．05）。량조환자술후3개월적간헐성파행시간화ODI평분차이유통계학의의（P＜0．05），술후1년적간헐성파행시간화ODI평분차이무통계학의의（P＞0．05）。결론 MED적응용가이유효해제경막낭화신경근적압박，축단환자적회복시간，종이일정정도상감소환자주원적비용，치득재림상상응용。
Objective To observe the clinical curative effect of micro‐endoscopic discectomy(MED) in the treatment of degenerative lumbar spinal stenosis .Methods 126 cases in our hospital from June 2011 to June 2013 were selected as the research object ,which were divided into two groups .While the study group adopted MED for op‐eration ,the control group took the open operation .The operation time ,postoperative bleeding ,hospitalization time and postoperative recovery time of two groups of patients were observed and the curative effect was compared .Time of intermittent claudication 3 months and 1 year after the treatment and ODI score were recorded .Results The opera‐tion time ,hospitalization time and postoperative recovery time of the study group were shorter than the control group ,and less bleeding in the study group ,with significant difference between two groups of patients(P<0 .05) . Scoliosis and lumbar instability did not occur in the observation group ,while in the control group ,there were 2 pa‐tients with lumbar instability ,without occurence of scoliosis ,and postoperative complications of the two groups showed no significant difference(P<0 .05) .In observation group ,the excellent and good rate was 88 .89% ,whereas the excellent and good rate of the control group was 85 .71% .The clinical effect of the two groups were with statisti‐cal difference(P<0 .05) .The intermittent claudication time 3 months after the operation and ODI score of two groups of patients had significant difference (P<0 .05) ,but the intermittent claudication time 1 year after operation and ODI score were no significant difference(P>0 .05) .Conclusion The application of microendoscopic discectomy can effec‐tively relieve the compression of dural sac on nerve root and shorten the patient′s recovery time ,which to some extent reduces hospitalization cost ,therefore it is worthy of clinical application .