小切口单侧半椎板切除入路在脊髓肿瘤手术治疗中的应用效果观察

Safety Analysis and Efficacy Observation of Small Incision Unilateral Hemilaminectomy Approach to the Treatment of Spinal Cord Tumors

目的比较不同手术方法治疗脊髓肿瘤的效果。方法选取2003年1月至2013年6月雅安市人民医院收治的脊髓肿瘤患者100例作为研究对象,采用随机数字表法分为两组,小切口单侧半椎板切除入路组(小切口单侧组)50例,传统全椎板入路组(传统全椎板组)50例。比较两组患者手术肿瘤切除情况,术后神经功能情况;最早下床时间(d)、住院时间(d)及并发症发生率。结果小切口单侧组患者手术肿瘤切除情况,术后神经功能情况均显著优于传统全椎板组(P<0.05)。小切口单侧组患者术后最早下床时间、住院时间分别为(11.8±4.2)d、(15.3±5.1)d,均显著短于传统全椎板组[(18.7±5.6)d、(27.1±7.3)d,(P<0.05)]。小切口单侧组患者并发症发生率为8.0%,显著低于传统全椎路组(26.0%)(P<0.05)。结论小切口单侧半椎板切除入路术式治疗脊髓肿瘤手术效果优于传统全椎板入路术式,而且对患者创伤小,患者术后恢复较快,并发症少,值得临床推广。

Objective To study the effects of different surgical approaches to the treatment of spinal cord tumors. Methods From Jan. 2013 to Jun. 2013,a total of 100 patients with spinal cord tumor admitted to Ya＇an People＇s Hospital were selected as study objects, and were randomly divided into two groups, namely one group with small incision unilateral hemilaminectomy approach,another group with traditional laminectomy approach. Comparison was conducted on patients in both groups in terms of tumor resection situation, postop- erative neurological condition,the earliest ambulation time（d） ,hospital stays（d） and occurrences of compli- cations. Results As for the group with small incision unilateral hemilaminectomy approach,patients＇ situa- tion of tumor resection and postoperative neurelogical condition were both better than those of the group with traditional laminectomy approach, with statistically significant difference （ P 〈 0.05 ）. Moreover, the earliest ambulation time of patients and their hospital stays were respectively （ 11.8 ±4.2 ） d, （ 15.3± 5.1 ） d, shorter than those of patients in the group with traditional laminectomy approach[ （ 18.7±5.6 ） d, （ 27.1± 7.3 ） d ], the differences were of statistical significance （ P 〈 0.05 ）. In addition, the occurence of complica- tions in the former was 8.0% , significantly lower than that in the latter（26.0% ） （ P 〈 0.05 ）. Conclusion The operation result of small incision unilateral hemilaminectomy approach is better than that of traditional laminectomy approach. It is of less trauma,faster postoperative recovery and fewer complications.