全椎板切开与半椎板切开在脊髓外硬膜下肿瘤切除中的临床应用分析

Clinical application analysis of total vertebral plate incision and half-vertebral plate incision in resection of spinal subdural tumor

目的探究全椎板切开与半椎板切开在脊髓外硬膜下肿瘤切除中的临床应用差异。方法回顾性分析2014年10月至2018年6月淮安市第一人民医院收治的58例椎管内脊髓外硬膜下肿瘤患者的临床资料,依据手术方式将其分为A组(37例)和B组(21例),A组患者采用全椎板切开切除椎管内肿瘤,B组患者采用半椎板切开切除椎管内肿瘤,收集并比较两组患者围手术期相关指标,包括肿瘤在椎管内相对位置、肿瘤最大径、手术时间、肿瘤手术切除程度、术后症状改善情况、术后并发症发生情况和抗生素使用情况。结果两组患者肿瘤椎管内相对位置比较差异有统计学意义(P<0.05)。两组患者肿瘤最大径、手术时间、肿瘤切除程度、术后症状改善、术后并发症发生情况、术后抗生素使用时间比较差异均无统计学意义(均P>0.05)。A组患者术中出血量显著多于B组(P<0.05)。结论全椎板切开与半椎板切开切除脊髓外硬膜下肿瘤均可取得良好的临床效果,但半椎板切开方式术中出血量少、损伤小,更适用于椎管内偏侧肿瘤的切除。

Objective To compare the clinical application difference between the total vertebral plate incision and half-vertebral plate incision in resection of spinal subdural tumor.Method The clinical data of 58 patients with spinal subdural tumor admitted to Huai'an First People's Hospital from October 2014 to June 2018 were retrospectively analyzed.The patients were divided into group A(37 cases)and group B(21 cases)according to the operation difference,patients in group A were treated with total vertebral plate incision,and patients in group B were treated with half-vertebral plate incision.Perioperative period indicators were collected and compared between the two groups,including the relative position of tumor in the spinal canal,the tumor size,operation time,the degree of surgical resection of the tumor,postoperative symptom improvement,postoperative complications,and antibiotic use.Result There was significant statistical difference in the relative position of tumor in the spinal canal between the two groups(P<0.05).There were no significant differences in tumor size,operation time,degree of tumor resection,postoperative symptom improvement,postoperative complications,and postoperative antibiotic duration between the two groups(all P>0.05).The amount of intraoperative blood loss in group A was significantly more than that in group B(P<0.05).Conclusion Both total vertebral plate incision and half-vertebral plate incision can achieve good clinical results in the resection of spinal subdural tumor,but half-vertebral plate incision is more suitable for the resection of lateral tumor in the spinal canal with less blood loss and less injury.