完全内镜下手术治疗单节段腰椎管狭窄症的临床效果

Clinical effect of complete endoscopic surgery for single-segment lumbar spinal stenosis

目的探讨完全内镜下手术治疗单节段腰椎管狭窄症的临床效果。方法选择本院2015年1月至2018年1月收治的44例单节段腰椎管狭窄症患者为研究对象,依据治疗方案的不同将其分为对照组和观察组,各22例。对照组行传统开放减压、后路椎间融合手术治疗,观察组行完全内镜下手术治疗。比较两组的手术时间、术中出血量、术后引流量、卧床时间、住院时间、手术不同时间的腰椎功能及疼痛程度。结果观察组手术时间长于对照组,术中出血量及术后引流量少于对照组,卧床时间及住院时间短于对照组,差异具有统计学意义(P<0.05)。术后3个月、术后6个月及术后1年,两组的ODI评分均低于术前1 d,差异具有统计学意义(P<0.05)。术后5 d,观察组的VAS评分低于对照组,差异具有统计学意义(P<0.05);术后5 d及术后3个月,两组的VAS评分均低于术前,差异具有统计学意义(P<0.05)。结论完全内镜下手术治疗可进一步减少单节段腰椎管狭窄症患者的术中出血量和术后引流量,可加快患者术后恢复速度并缩短住院时间,应用价值较高。

Objective To investigate the clinical effect of complete endoscopic surgery for single-segment lumbar spinal stenosis.Methods A total of 44 patients with single-segment lumbar spinal stenosis who were treated in our hospital from January 2015 to January 2018 were selected as the research objects.The patients were divided into control group and observation group according to the different treatment plan,with 22 cases in each group.The control group underwent traditional open surgery decompression and posterior intervertebral fusion surgery,and the observation group underwent complete endoscopic surgery.The operation time,intraoperative blood loss,postoperative drainage volume,time of bed rest,hospital stay,lumbar spine function and pain degree at different times of the two groups were compared.Results The time of operation in the observation group was longer than that in the control group,the intraoperative blood loss and the postoperative drainage volume were less than those in the control group,and the time of bed rest and hospital stay were shorter than those in the control group,the differences were statistically significant(P<0.05).Three months,six months and one year after operation,the ODI scores of the two groups were lower than those at one day before operation,the differences were statistically significant(P<0.05);at 5 days after operation,the VAS score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05);at 5 days and 3 months after operation,the VAS scores of the two groups were lower than those before operation,and the differences were statistically significant(P<0.05).Conclusion Complete endoscopic surgery can further reduce the intraoperative bleeding volume and postoperative drainage volume of patients with single-segment lumbar spinal stenosis,accelerate the postoperative recovery speed and shorten the hospital stay,with high application value.