手术治疗520例腰椎间盘突出症患者的疗效判定及术后并发症的原因探讨

The reasons and countermeasures of postoperative poor results for the lumbar disc herniation patients

目的分析腰椎间盘突出症的手术患者术后疗效，总结部分临床效果不佳的原因，提出预防的对策和措施。方法通过对1996年～2006年我院520例经手术治疗的腰椎盘突出症患者的病历进行分析统计，判定其术后疗效，分析其术后并发症的种类。结果术后疗效评定根据改良Macnab标准：优：286例，良：134例，可：78例，差：22例，优良率80．7％。结论针对腰椎间盘突出症的患者，术前应仔细查体、定位、诊断，认真评估，严格把握手术适应证，做好术前准备；术中操作要谨慎、有序，充分暴露，认真探查，小心剥离，彻底减压；术后要精心护理，加强功能锻炼。这样才能有效避免部分并发症，达到满意的疗效。

Objective To analyze the postoperative curative effect of lumbar disc herniation surgery patients, as well as some of the reasons for the poor clinical results, the preventive measures and countermeasures. Method Discussed 520 cases of lumbar disc herniation surgery patients in our hospital through 1996 -2006, analyzed, summarized information retrospectively. Results According to the modified Macnab therapeutic evaluation standards ： best ： 286 cases, better： 134 cases, good ： 78 cases, poor： 22 cases, excellent ratio 80.7%. Conclusions For the patients with lumbar disc herniation, the effect of surgery treatment is based on strict surgical indications, serious preoperative preparation： careful body positioning, diagnosis, assessment of the operation, and serious exploration and careful dissection and thorough decompression;and meticulous postoperativ care, strengthened functional exercise.