基于骨钻的后外侧入路脊柱内镜术后渗出与术后反应的相关性分析

Correlation analysis between postoperative exudation and response after posterolateral endoscopic spine surgery based on bone drill

目的观察术后引流、甘露醇静脉滴注对基于螺旋骨钻的后外侧路脊柱内镜下神经松解术后患者并发症的影响。方法选择腰椎间盘突出神经根病患者69例进行前瞻性研究,随机分为对照组、治疗1组、治疗2组各23例。对照组给予常规手术治疗;治疗1组给予常规手术+甘露醇静脉滴注治疗;治疗2组给予常规手术+术后引流治疗。比较3组治疗前后腰与下肢痛的数字评分法(Numerical Rating Scale,NRS)评分、日本骨科协会(Japanese Orthopaedic Association,JOA)评分。结果 3组NRS评分、JOA评分组间、时点间、组间·时点间交互作用差异均有统计学意义(P<0.01),治疗2组优于治疗1组,治疗1组优于对照组。结论基于螺旋骨钻的后外侧路脊柱内镜下神经松解术的术后渗出应用术后引流和甘露醇静脉滴注与以往单独手术比较,对术后并发症有显著疗效。

Objective To observe the effect of postoperative drainage and intravenous mannitol infusion on the complications of posterolateral spinal endoscopic neurolysis based on spiral drill.Methods A retrospective analysis of 69 cases of lumbar disc herniation with radiculopathy patients, who divided into control group, treatment group 1, treatment group 2 was used. The control group was given routine operation, the treatment group 1 was given routine operation＋mannitol intravenous drip treatment; the treatment group 2 was given routine operation＋postoperative drainage treatment. The Numerical Rating Scale（NRS ） scores and Japanese Orthopaedic Association（JOA） scores were compared in the 3 groups before and after treatment.Results There were significant differences of interblock, time dissimilarity, and interaction of interblock with time dissimilarity among the 3 groups for NRS scores and JOA scores（ P 〈 0.01）. The treatment group 2 was superior to the treatment group 1, and the treatment group 1 was superior to the control group.Conclusion Postoperative drainage and intravenous mannitol infusion for posterolateral spinal endoscopic neurolysis based on spiral drill are more effective than previous single operation for postoperative complications.