影响腰椎间盘突出症患者腰神经根减压术后神经功能恢复效果的危险因素分析

Risk factors of neurological function recovery in patients with lumbar disc herniation after lumbar nerve root decompression

目的探讨影响腰椎间盘突出症(LDH)患者腰神经根减压术后神经功能恢复效果的危险因素。方法收集2012-02-2015-01于我院接受腰神经根减压术的96例LDH患者的临床资料,所有患者术后均有明确神经功能测定结果,回顾性分析所有患者临床资料,采用单因素及多元Logistic回归分析筛选影响LDH患者腰神经根减压术后神经功能恢复的相关因素。结果(1)本组患者术后神经功能恢复不佳18例,占18.75%。(2)单因素分析显示,恢复不佳组年龄≥50岁、病程>12个月、术VAS评分≥5分、既往外伤史、L3-4节段突出、合并神经根粘连所占比例均高于恢复良好组,对比差异有统计学意义(P<0.05)。(3)多元Logistic回归分析显示:年龄、病程、术前VAS评分、既往外伤史、合并神经根粘连是影响LDH患者术后神经功能恢复的独立危险因素(P<0.05)。结论年龄、病程、术前VAS评分、外伤史、神经根粘连均为影响LDH患者腰神经根减压术后神经功能恢复的独立危险因素,积极控制其危险因素,有助于患者术后神经功能的改善。

Objective To explore the risk factors of neurological function recovery in patients with lumbar disc herniation（LDH） after lumbar nerve root decompression. Methods The clinical data of 96 patients with LDH treated by lumbar nerve root decompression in our hospital from February2012 to January 2015 were collected. The neurological function in all patients was determined, and the clinical data were retrospectively analyzed. The related factors that influencing the neurological function recovery in patients with LDH after lumbar nerve root decompression were screened by univariate and multivariate Logistic regression analysis. Results（1）There were 18 patients with poor recovery of neurological function in this study, accounting for 18.75%.（2） Univariate analysis showed that the proportions of patients who were or older than 50 years old, patients whose course of disease was longer than 12 months, patients whose VAS score was 5 points, patients with previous history of trauma, patients with L3 ~4 segment herniation and patients with nerve root adhesion in the poor recovery group were higher than those in the good recovery group（P〈0.05）.（3） Multivariate Logistic regression analysis showed that age, course of disease, preoperative VAS score, history of trauma and nerve root adhesion were independent risk factors for the neurological function recovery in patients with LDH after operation（P〈0.05）. Conclusion Age, course of disease, preoperative VAS score, history of trauma and nerve root adhesion are independent risk factors influencing the neurological function recovery in patients with LDH after lumbar nerve root decompression. Active control of risk factors can help the improvement of neurological function in patients after operation.