中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
Chinese Journal of Experimental Surgery
2015年
11期
2881-2883
,共3页
李立人%皮国富%刘宏建%韩钰%孙建广
李立人%皮國富%劉宏建%韓鈺%孫建廣
리립인%피국부%류굉건%한옥%손건엄
腰椎间盘突出症%单纯髓核摘除术%微创
腰椎間盤突齣癥%單純髓覈摘除術%微創
요추간반돌출증%단순수핵적제술%미창
Lumbar disc herniation%Simple extraction of nucleus pulposus%Minimally Invasive
目的 比较通道下微创经椎间孔髓核摘除术与传统切开后路椎间盘髓核摘除术(PLIE)对单节段腰椎间盘突出症的近期治疗效果.方法 选择采用通道微创手术的患者19例、传统后路手术治疗的患者23例,比较两组术中出血量、手术时间、术后切口引流量、下床活动时间及平均住院日等,并采用日本骨科协会(JOA)评分、疼痛视觉模拟评分(VAS)评分进行临床疗效评定.评价其总体手术效果和疗效差异.结果 微创组术前JOA、VAS评分分别为(7.70 ±3.70)、(8.30±1.00)分,术后分别为(26.30±1.50)、(2.20±1.00)分,两者差异均有统计学意义(P＜0.05).开放组术前JOA、VAS评分分别为(7.20±4.10)、(8.90±0.70)分,术后分别为(25.70±1.50)、(2.45±0.90)分,两者差异均有统计学意义(P＜0.05).关于术中出血量、手术时间、术后下地时间、平均住院日及JOA评分改善率,微创组为(61.15±32.00) ml、(81.15±30.00) min、(2.65±0.74)d、(6.60±1.40)d、(87.70±0.05)％,开放组为(98.80±32.00) ml、(75.05±22.00) min、(12.20±3.94)d、(12.15±1.20)d、(85.50±0.54)％.微创组均未放置引流管,开放组术后引流量为(8.55±3.60) ml.两组手术时间、JOA评分改善率及VAS评分差异无统计学意义(P＞0.05).微创组术中出血量、手术时间、术后下地时间、平均住院日均低于开放组,差异有统计学意义(P＜0.05).结论 与开放组比较,微创组对于单节段腰椎间盘突出症同样具有良好的近期治疗效果,但在术中出血量、术后引流量、术后下地时间、平均住院日方面优于开放组.
目的 比較通道下微創經椎間孔髓覈摘除術與傳統切開後路椎間盤髓覈摘除術(PLIE)對單節段腰椎間盤突齣癥的近期治療效果.方法 選擇採用通道微創手術的患者19例、傳統後路手術治療的患者23例,比較兩組術中齣血量、手術時間、術後切口引流量、下床活動時間及平均住院日等,併採用日本骨科協會(JOA)評分、疼痛視覺模擬評分(VAS)評分進行臨床療效評定.評價其總體手術效果和療效差異.結果 微創組術前JOA、VAS評分分彆為(7.70 ±3.70)、(8.30±1.00)分,術後分彆為(26.30±1.50)、(2.20±1.00)分,兩者差異均有統計學意義(P＜0.05).開放組術前JOA、VAS評分分彆為(7.20±4.10)、(8.90±0.70)分,術後分彆為(25.70±1.50)、(2.45±0.90)分,兩者差異均有統計學意義(P＜0.05).關于術中齣血量、手術時間、術後下地時間、平均住院日及JOA評分改善率,微創組為(61.15±32.00) ml、(81.15±30.00) min、(2.65±0.74)d、(6.60±1.40)d、(87.70±0.05)％,開放組為(98.80±32.00) ml、(75.05±22.00) min、(12.20±3.94)d、(12.15±1.20)d、(85.50±0.54)％.微創組均未放置引流管,開放組術後引流量為(8.55±3.60) ml.兩組手術時間、JOA評分改善率及VAS評分差異無統計學意義(P＞0.05).微創組術中齣血量、手術時間、術後下地時間、平均住院日均低于開放組,差異有統計學意義(P＜0.05).結論 與開放組比較,微創組對于單節段腰椎間盤突齣癥同樣具有良好的近期治療效果,但在術中齣血量、術後引流量、術後下地時間、平均住院日方麵優于開放組.
목적 비교통도하미창경추간공수핵적제술여전통절개후로추간반수핵적제술(PLIE)대단절단요추간반돌출증적근기치료효과.방법 선택채용통도미창수술적환자19례、전통후로수술치료적환자23례,비교량조술중출혈량、수술시간、술후절구인류량、하상활동시간급평균주원일등,병채용일본골과협회(JOA)평분、동통시각모의평분(VAS)평분진행림상료효평정.평개기총체수술효과화료효차이.결과 미창조술전JOA、VAS평분분별위(7.70 ±3.70)、(8.30±1.00)분,술후분별위(26.30±1.50)、(2.20±1.00)분,량자차이균유통계학의의(P＜0.05).개방조술전JOA、VAS평분분별위(7.20±4.10)、(8.90±0.70)분,술후분별위(25.70±1.50)、(2.45±0.90)분,량자차이균유통계학의의(P＜0.05).관우술중출혈량、수술시간、술후하지시간、평균주원일급JOA평분개선솔,미창조위(61.15±32.00) ml、(81.15±30.00) min、(2.65±0.74)d、(6.60±1.40)d、(87.70±0.05)％,개방조위(98.80±32.00) ml、(75.05±22.00) min、(12.20±3.94)d、(12.15±1.20)d、(85.50±0.54)％.미창조균미방치인류관,개방조술후인류량위(8.55±3.60) ml.량조수술시간、JOA평분개선솔급VAS평분차이무통계학의의(P＞0.05).미창조술중출혈량、수술시간、술후하지시간、평균주원일균저우개방조,차이유통계학의의(P＜0.05).결론 여개방조비교,미창조대우단절단요추간반돌출증동양구유량호적근기치료효과,단재술중출혈량、술후인류량、술후하지시간、평균주원일방면우우개방조.
Objective To compare the short-term outcomes of minumally invasive discetomy via a tube by Wiltse approach vs.the traditional posterior lumbar interbody extripate (PLIE) treatment for single-level lumbar intervertebral disc herniation.Methods During March 2014 to October 2014, 42 patients with single-level lumbar intervertebral disc herniation underwent simple extraction of nucleus pulposus.They were divided into two groups according to the operation method.Nineteen patients were given minimally invasive discetomy via a tube by Wiltse approach as mini-invasive group, and 23 patients in the PLIE group were subjected to the traditional posterior lumbar interbody extricate.The short-term clinical outcomes of two groups were compared in respect of the perioperative blood loss, operative time, postoperative ambulation time, postoperative drainage volume, average hospital stay the scores about Japanese Orthopaedic Association (JOA) score, and Visual Analogue Score (VAS).Results In mini-invasive group, perioperative blood loss was (61.15 ± 32.00) ml, operative time was (81.15 ± 30.00) min, postoperative ambulation time was (2.65 ± 0.74) days, average hospital stay was (6.60 ± 1.40) days, rate of the improved JOA score was (87.70 ± 0.05) ％.The JOA score was (7.70 ± 3.70) pre-operation and (26.30 ± 1.50) post-operation.The VAS score was (8.30 ± 1.00) pre-operation and (2.20 ± 1.00) post-operation.There was statistically significant diffierence in JOA and VSA scores pre-operation and post-operation (P ＜ 0.05).In mini-invasive group, the drainage tube was not placed.In PLIE group, perioperative blood loss was (98.80 ±32.00) ml, operative time was (75.05 ±22.00) min, postoperative ambulation time was (12.20 ± 3.94) days, average hospital stay was (12.15 ± 1.20) days, postoperative drainage volume was (8.55 ± 3.60) ml, and rate of the improved JOA score was (85.50 ± 0.54) ％.The JOA score was (7.20 ±4.10) pre-operation and (25.70 ± 1.50) post-operation.The VAS score was (8.90 ± 0.70) pre-operation and (2.45 ± 0.90) post-operation.There was statistically significant diffierence in the above indexes pre-operation and post-operation (P ＜ 0.05).There was no statistically significant diffierence in the operative time and rate of the improved JOA score (P ＞ 0.05).There was also statistically significant diffierence in the perioperative blood loss, postoperative drainage volume, postoperative ambulation time, and average hospital stay between the two groups (P ＜ 0.05).Conclusion Both the minumally invasive discetomy group and PLIE group have the similar good short-term outcones of single-level lumbar intervertebral disc herniation, but as for the perioperative blood loss, postoperative drainage volune, postoperative ambulation time and average hospital stay, minumally invasive discetomy group is superior to PLIE group.
