半椎板对比全椎板显微入路手术治疗椎管内肿瘤的疗效及对颈椎稳定性的影响

Comparative Analysis of the Effect of Hemi Laminectomy and Total Laminectomy on the Intraspinal Tumor and the Stability of Cervical Vertebra

目的探讨半椎板与全椎板显微入路手术治疗椎管内肿瘤的疗效及对颈椎稳定性的影响。方法将行锥管内肿瘤切除术的138例患者根据数字表法随机分为对照组和观察组,每组69例。观察组采用半椎板显微入路手术,对照组采用传统全椎板显微入路手术。对2组患者术后临床效果、并发症发生率以及术后6个月的疗效进行对比与分析。结果观察组在术中时间、术中出血量、术后下床时间以及住院时间方面显著低于对照组,差异有统计学意义(P<0. 05)。术后观察组并发症发生率为8. 70%,对照组并发症发生率为24. 64%,组间差异具有统计学意义(P <0. 05);术后6个月,观察组有效率和脊柱稳定性分别为89. 56%和85. 51%,对照组分别为72. 46%和79. 71%,组间比较,观察组效果更显著(P <0. 05)。结论半椎体显微入路手术在椎管内肿瘤切除术中能最大限度地保存脊柱组织完整性,有利于脊柱稳定,同时手术创伤更小,恢复速度更快。

Objective To compare the curative effect of the intraspinal tumor with the semi laminectomy and the total laminectomy. Methods 138 cases of patients during the period from June 2016 to September 2017 in our hospital for taper pipe tumor resection,according to randomly divided into control group and observation group,69 cases in each group;the observation group were treated with laminectomy approach surgery,the control group used the traditional laminectomy approach of micro surgery;contrast clinical analysis of 6 months of the two groups of patients with clinical effect,complication rate and postoperative.Results The patients in the observation group in the operation time,intraoperative bleeding volume,postoperative ambulation time and hospitalization time was significantly lower than the control group,the difference was statistically significant( P < 0. 05);the complication rate of observation group was 8. 70% after operation in the two groups,the control group complication rate was24. 64%,the comparison between groups had statistical significance( P < 0. 05);At 6 months after operation,the effective rate and spinal stability of the observation group were 89. 56% and 85. 51%,respectively,and the control group was 72. 46%、79. 71%,which was more significant in the observation group than in the control group( P < 0. 05). Conclusion Hemivertebra microsurgery can preserve the integrity of spinal tissue to the maximum extent during spinal canal tumor resection,which is good for spinal stabilization,and has less operative trauma and faster recovery.