腰后路显微手术治疗腰椎间盘突出症的疗效及其炎性状态变化研究

Effect of lumbar posterior microsurgical operation in the treatment of prolapse of lumbar intervertebral disc and the change of inflammatory state

目的探讨腰后路显微手术治疗腰椎间盘突出症的临床疗效及围术期患者的炎性状态变化规律。方法选取2010年1月至2012年7月于东莞市大岭山医院采用腰后路显微手术进行治疗的31例腰椎间盘突出症患者为观察组,同期采用开放式手术进行治疗的31例患者为对照组,对两组患者的治疗优良率、手术时间、术中出血量、术后VAS评分、并发症发生率、下地活动时间、住院时间及术前、术后1、3、7d的血清CRP、IL-1β、IL-6、IL-8及TNF-α水平进行比较。结果观察组的治疗优良率高于对照组,手术时间、下地活动时间及住院时间均短于对照组,术中出血量小于对照组,术后VAS评分低于对照组,并发症发生率低于对照组,术后1、3、7d的血清CRP、IL-1β、IL-6、IL-8及TNF-α水平均低于对照组,其差异均有统计学意义(P均<0.05)。结论腰后路显微手术治疗腰椎间盘突出症的疗效较佳,且其炎性指标波动也更小,反映出手术对机体的不良影响更小。

Objective To study the clinical effect of lumbar posterior microsurgical operation in the treat- ment of prolapse of lumbar intervertebral disc and the variation of inflammatory state during the perioperative period. Methods Thirty-one patients with prolapse of lumbar intervertebral disc who were treated with lumbar posterior mi- crosurgical operation in our hospital from January 2010 to July 2012 were selected as the observation group, and 31 patients who were treated with open operation at the same time were selected as the control group. Then the excellent and good rate, operation time, blood loss during the operation, VAS score after operation, incidence of complications, bed activity time, length of hospital stay and serum CRP, IL-lfl, IL-6, L-8, TNF-ct before and after operation at the first, third and seventh day of the two groups were compared. Results The excellent and good rate of the observation group was significantly higher than that of the control group, and the operation time, bed activity time and length of hospital stay were significantly shorter than those of the control group. The blood loss during the operation was signifi- cantly less in the observation group than the control group, VAS score after operation and the incidence of complica- tions were significantly lower. Serum CRP, IL-1β, IL-6, L-8, TNF-α after operation at the first, third and seventh day were significantly lower than those of the control group, P〈0.05. Conclusion The effect of lumbar posterior micro- surgical operation in patients with prolapse of lumbar intervertebral disc is better, and the fluctuation of inflammatory indexes is smaller, which indicates the bad influence for the patients is smaller.