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联勤保障部队第909医院/厦门大学附属东南医院骨科
纸质出版日期:2022,
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陈少丽, 康媛, 任苗苗. 斜外侧入路腰椎椎体间融合术治疗腰椎管狭窄症的效果[J]. 保健医学研究与实践, 2022,19(4):55-59.
Chen Shaoli, Kang Yuan, Ren Miaomiao. Efficacy of oblique lumbar interbody fusion for lumbar spinal stenosis[J]. Health Medicine Research and Practice, 2022,19(4):55-59.
目的 探讨斜外侧入路腰椎椎体间融合术治疗对腰椎管狭窄症患者围手术指标、创伤应激指标及Oswestry功能障碍指数量表(ODI)评分的影响。方法 选取2016年12月—2019年12月漳州市某医院收治的90例腰椎管狭窄症患者
采用随机数字表法分为对照组(46例)与观察组(44例)。对照组患者采用后路腰椎椎体间融合术治疗
观察组患者采用斜外侧入路腰椎椎体间融合术治疗
比较2组患者围手术期指标
手术前后视觉模拟评分量表(VAS)评分、ODI评分、血清C反应蛋白(CRP)、肌酸激酶(CK)水平及术后并发症发生情况。结果 观察组患者术中出血量、引流量少于对照组
下地活动时间、住院时间短于对照组
差异均有统计学意义(P
<
0.05)。2组患者术后3个月及术后6个月VAS、ODI评分低于术前
且观察组低于对照组
差异均有统计学意义(P
<
0.05)。2组患者术后12 h、24 h、48 h血清CRP、CK水平高于术前
术后48 h血清CRP、CK水平低于术后12 h、24 h
且观察组术后12 h、24 h、48 h血清CRP、CK水平均低于对照组
差异均有统计学意义(P
<
0.05)。观察组患者术后并发症发生率为4.55%(2/44)
低于对照组的15.57%(9/46)
差异有统计学意义(χ
=
4.729
P=0.030)。结论 斜外侧入路腰椎椎体间融合术治疗腰椎管狭窄症安全性高于后入路手术
患者术后组织创伤应激反应小
术后疼痛感较轻
能促进患者腰椎功能恢复。
Objective To investigate the effects of oblique lumbar interbody fusion treatment on the perioperative indexes
traumatic stress indexes and Oswestry dysfunction index(ODI) scores of patients with lumbar spinal stenosis. Methods Ninety patients with lumbar spinal stenosis admitted to a hospital in Zhangzhou from December 2016 to December 2019 were selected and divided into a control group(46 cases) and an observation group(44 cases) using a random number table. Patients in the control group were treated with posterior lumbar interbody fusion and patients in the observation group were treated with oblique lumbar interbody fusion
and the perioperative indexes
pre-and postoperative visual analog scale(VAS) scores
ODI scores
serum C-reactive protein(CRP) and creatine kinase(CK) levels and postoperative complications in the two groups were compared. Results The intraoperative bleeding and drainage were less in the observation group than in the control group
and the time to ambulation and hospital stay were shorter than those in the control group
all with statistically significant differences(P
<
0.05). The VAS and ODI scores at 3 and 6 months after surgery were lower than those before surgery and lower in the observation group than in the control group
with statistically significant differences(P
<
0.05). The serum CRP and CK levels in the 2 groups were higher at 12 h
24 h and 48 h after surgery than before surgery
and lower the serum CRP and CK levels at 48 h after surgery than at 12 h and 24 h after surgery
and the serum CRP and CK levels in the observation group were lower than those in the control group at 12 h
24 h and 48 h after surgery
all with statistically significant differences(P
<
0.05).The incidence of postoperative complications was 4.55%(2/44) in the observation group
which was lower than that of 15.57%(9/46) in the control group
and the difference was statistically significant(χ
=
4.729
P=0.030). Conclusion Oblique lumbar interbody fusion for lumbar spinal stenosis is safer than the posterior approach
and patients have less postoperative tissue trauma stress and less postoperative pain
which can promote the recovery of lumbar spine function.
斜外侧入路腰椎椎体间融合术腰椎管狭窄症围手术指标创伤应激ODI指数
Oblique lateral approachLumbar interbody fusionLumbar spinal stenosisPerioperative indexTraumatic stressODI index
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