显微镜与显微内窥镜下手术治疗老年腰椎管狭窄的临床疗效比较

A comparative study on the clinical efficacy of treatment under the microscope or micro endoscopic in elderly lumbar spinal stenosis patients

目的:探讨显微镜与显微内窥镜下手术治疗老年腰椎管狭窄的临床疗效及安全性。方法:将90例老年腰椎管狭窄患者运用随机数字表法分为显微镜组(n=45)和显微内窥镜组(n=45),两组分别采用显微镜下手术和显微内窥镜下手术治疗腰椎管狭窄,比较两组患者各项临床指标。结果:两组患者手术时间、术中出血量、术后住院时间、术后平均下床时间、术后并发症发生率和患者综合满意度比较,差异均无统计学意义(均P>0.05)。治疗前后两组视觉模拟评分、JOA评分和Oswestry功能障碍指数比较,差异均无统计学意义(均P>0.05)。治疗后,两组患者视觉模拟评分、JOA评分和Oswestry功能障碍指数均明显优于治疗前,差异有统计学意义(P<0.05)。显微内窥镜组中转开放手术率明显高于显微镜组,差异有统计学意义(P<0.05),显微内窥镜组手术切口长度明显短于显微镜组,差异有统计学意义(P<0.05)。结论:显微镜下手术治疗腰椎管狭窄症疗效确切,临床技术更易掌握,较易于临床推广,尤其是基层医院。

Objective： To investigate the clinical efficacy of treatment under the microscope or micro endoscopic in elderly lumbar spinal stenosis patients. Methods： Ninety elderly lumbar spinal stenosis patients were divided into the microscope group（ n = 45 ） and the micro endoscopic group （n = 45 ） by random number table, they were given surgery under the microscope and under the micro endoscopic, respectively, the clinical indicators of two groups was evaluated. Results： There were no different between two groups in the operation time, intraoperative bleeding, postoperative length of hospital stay, postoperative average down time, postoperative complications and patient satisfaction（ all P 〉 0.05）. There were no different between two groups in visual analogue scale, JOA score and oswestry disability index before and after treatment（ all P 〉 0.05 ）. The visual analogue scale, JOA score and oswestry disability index were better after treatment than that before treatment （ all P 〈 0.05 ）. Transfering rate of open surgery in micro endoscopic grout3 was hi^her than that of microscoe a, roun （P 〈 . 05 ）. The incision lengthin micro endoscopic group was shorter than that of microscope group （ P 〈 0.05 ）. of microscopic in treatment of elderly patients with lumbar spinal stenosis disease the broader and clinical promotion, especially in grass-roots hospitals. Conclusion： The clinical is sure. It is more easy to efficacy adapt to