单侧椎板开窗髓核摘除术治疗脱垂型腰椎间盘突出症的临床疗效及机制研究

Clinical Curative Effect and Study on Mechanism of Unilateral Laminectomy for Extirpation of Nucleus Pulposus in Treatment of Prolapse of Lumbar Intervertebral Disc Herniation

目的探索研究腰椎间盘突出症患者应用单侧椎板开窗髓核摘除术进行治疗的临床疗效。方法以2016年10月—2017年10月来该院进行治疗的128例腰椎间盘突出症患者为研究对象,将其随机分为实验组和对照组,对照组64例采用传统椎板间隙开窗摘除术进行治疗,实验组64例患者采用单侧椎板开窗髓核摘除术进行治疗,比较两组患者的出血量、手术时间、住院时间、疗效。结果实验组患者的住院时间是(7.5±1.3)d明显少于对照组的(11.2±2.8)d,差异有统计学意义(t=5.667,P<0.05)。对照组手术时间(75.2±11.8)min、术中出血量(153.8±19.7)mL,实验组患者的手术时间、出血量均明显少于对照组,差异有统计学意义(t=5.667、6.831,P<0.05);术后实验组的JOA评分改善率(87.1±10.2)%显著优于对照组(65.4±16.6)%,差异有统计学意义(t=6.678,P<0.05)。术后实验组ODI评分的改善率(27.1±11.2)%显著优于对照组(39.8±19.6)%,差异有统计学意义(t=8.651,P<0.05)。结论单侧椎板开窗髓核摘除术治疗腰椎间盘突出症患者具有术中损伤小、失血量少,易恢复、疗效好的优点,值得临床推广应用。

Objective To study and research the curative effect and study on mechanism of unilateral laminectomy for extirpation of nucleus pulposus in treatment of prolapse of lumbar intervertebral disc herniation. Methods 128 cases of patients with prolapse of lumbar intervertebral disc herniation admitted and treated in our hospital from October 2016 to October 2017 were selected and randomly divided into two groups with 64 cases in each, the control group were treated with traditional extirpation of fenestration of intervertebral space, while the experimental group were treated with unilateral laminectomy for extirpation of nucleus pulposus, and the hemorrhage volume, operation time, length of stay and curative effect were compared between the two groups. Results The length of stay in the experimental group was obviously lower than that in the control group [（7.5±1.3）d vs （ll.2±2.8）d],the different was statistically significant （t= 5.667,P〈0.05）, and the operation time and intraoperative bleeding amount in the control group were respectively （75.2±ll.8）min and （153.8±19.7）mL, and the operation time and hemorrhage volume in the experimental group were ob viously lower than those in the control group, and the differences were obvious （ t=5.667, 6.831, P〈0.05）, and the im- provement rate of JOA score in the experimental group after surgery was obviously better than that in the control group, [（87.1±10.2）% vs （65.4±16.6）%]the difference was statistically signficant（t=6.678,P〈0.05）, and the ODI score improve- merit rate in the experimental group after surgetry was obviously better than that in the control group,the difference was statistically signficant[（27.1±ll.2）% vs （39.8±19.6）%], and the difference was statistically significant （t=8.651, P〈0.05） . Conclusion The intraoperative injury of unilateral laminectomy for extirpation of nucleus pulposus in treatment of pro lapse of lumbar intervertebral disc herniation is small with less blood loss, easy recovery and good curative effect, and it is worth clinical promotion and application.