临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2015年
9期
745-747,748
,共4页
多节段脊髓型颈椎病%分节段减压融合术%传统椎体次全切除融合术
多節段脊髓型頸椎病%分節段減壓融閤術%傳統椎體次全切除融閤術
다절단척수형경추병%분절단감압융합술%전통추체차전절제융합술
Segmental myelopathic type with multiple cervical spondylosis%Segmental decompression fusion%Traditional vertebral body subtotal resection arthrodesis
目的：对比分析治疗多节段脊髓型颈椎病采用分节段减压融合术与传统椎体次全切除融合术的中远期临床效果。方法选取2012年6月到2014年11月接受手术治疗的110例多节段脊髓型颈椎病患者，根据手术方法进行分组，对照组患者实行传统椎体次全切除融合术，实验组患者实行分节段减压融合术，对比分析两组患者的临床手术指标以及中远期临床疗效。结果实验组的手术时间显著多于对照组，失血量显著少于对照组，差异有统计学意义（ P<0.05）。实验组患者中远期的融合节段角度（8.45±4.83）°、全颈椎增加角度（12.89±4.27）°显著低于对照组患者中远期的融合节段角度（10.55±2.87）°、全颈椎增加角度（14.45±4.72）°；两组患者在手术前、术后1个月和6个月的中期的 JOA 脊髓功能评分和 JOA 脊髓功能改善率差异无统计学意义（ P >0.05）；实验组患者在术后12个月和18个月的远期的 JOA 脊髓功能评分和 JOA 脊髓功能改善率显著优于对照组，差异有统计学意义（ P <0.05）。结论分节段减压融合术治疗多节段脊髓型颈椎病的中远期临床效果优于传统椎体次全切除融合术，具有重要临床应用价值。
目的：對比分析治療多節段脊髓型頸椎病採用分節段減壓融閤術與傳統椎體次全切除融閤術的中遠期臨床效果。方法選取2012年6月到2014年11月接受手術治療的110例多節段脊髓型頸椎病患者，根據手術方法進行分組，對照組患者實行傳統椎體次全切除融閤術，實驗組患者實行分節段減壓融閤術，對比分析兩組患者的臨床手術指標以及中遠期臨床療效。結果實驗組的手術時間顯著多于對照組，失血量顯著少于對照組，差異有統計學意義（ P<0.05）。實驗組患者中遠期的融閤節段角度（8.45±4.83）°、全頸椎增加角度（12.89±4.27）°顯著低于對照組患者中遠期的融閤節段角度（10.55±2.87）°、全頸椎增加角度（14.45±4.72）°；兩組患者在手術前、術後1箇月和6箇月的中期的 JOA 脊髓功能評分和 JOA 脊髓功能改善率差異無統計學意義（ P >0.05）；實驗組患者在術後12箇月和18箇月的遠期的 JOA 脊髓功能評分和 JOA 脊髓功能改善率顯著優于對照組，差異有統計學意義（ P <0.05）。結論分節段減壓融閤術治療多節段脊髓型頸椎病的中遠期臨床效果優于傳統椎體次全切除融閤術，具有重要臨床應用價值。
목적：대비분석치료다절단척수형경추병채용분절단감압융합술여전통추체차전절제융합술적중원기림상효과。방법선취2012년6월도2014년11월접수수술치료적110례다절단척수형경추병환자，근거수술방법진행분조，대조조환자실행전통추체차전절제융합술，실험조환자실행분절단감압융합술，대비분석량조환자적림상수술지표이급중원기림상료효。결과실험조적수술시간현저다우대조조，실혈량현저소우대조조，차이유통계학의의（ P<0.05）。실험조환자중원기적융합절단각도（8.45±4.83）°、전경추증가각도（12.89±4.27）°현저저우대조조환자중원기적융합절단각도（10.55±2.87）°、전경추증가각도（14.45±4.72）°；량조환자재수술전、술후1개월화6개월적중기적 JOA 척수공능평분화 JOA 척수공능개선솔차이무통계학의의（ P >0.05）；실험조환자재술후12개월화18개월적원기적 JOA 척수공능평분화 JOA 척수공능개선솔현저우우대조조，차이유통계학의의（ P <0.05）。결론분절단감압융합술치료다절단척수형경추병적중원기림상효과우우전통추체차전절제융합술，구유중요림상응용개치。
Objective To comparatively analyze the long - term clinical effect in treatment of multi - segmental myelopathic type cervical vertebra disease by using segmental decompression fusion with traditional total excision of vertebral bodies. Methods A total of 110 patients with multi - segmental spondylotic myelopathy underwent surgical treatment in this hospital during June 2012 to November 2014 were divided into trial group and control group according to the procedures of operation,patients in control group were treated with traditional vertebral body subtotal re-section and arthrodesis,and patients in trial group were treated with segmental decompression and fusion,and the clinical indicators as well as long- term clinical effect were comparatively analyzed between these two groups. Results The operating time in trial group was significantly more lon-ger than that of control group,and the amount of blood loss was significantly less than that of control group. The long - term prospective fusion seg-mental angle in patients of trial group was(8. 45 ± 4. 83)°,the angle of whole cervical spine increased(12. 89 ± 4. 27)° ,and the angle of fu-sion segments was significantly lower than that of patients in control group with long - term point of view of(10. 55 ± 2. 87)°,whole increased cervical angle was(14. 45 ± 4. 72)°. The difference in mid term JOA scores and functional improvement rate of spinal cord function in patients of 2 groups before surgery,and after 1 month and 6 months was not significant( P > 0. 05). The long - term JOA spinal cord function scores and functional improvement in patients of trial group after 12 months and 18 months were significantly better than those of patients in control group,and the difference was statistically significant( P < 0. 05). Conclusion The long - term clinical effect of segmental decompression and fusion in treatment of cervical spondylosis with multiple segmental myelopathic type has significant advantages,hence it has important value in clinical appli-cation.
