全椎板切开与半椎板切开在脊髓外硬膜下肿瘤切除中的应用价值比较

Comparison of the application value of total laminotomy and hemilaminotomy in the resection of extraspinal subdural tumors

目的比较全椎板切开与半椎板切开在脊髓外硬膜下肿瘤切除中的应用价值。方法选择2021年9月至2023年9月在周口市中心医院行脊髓外硬膜下肿瘤切除术患者66例为研究对象。按照随机数字表法分为对照组与研究组,每组33例。对照组采取全椎板切开治疗,研究组采取半椎板切开治疗。比较两组临床效果、手术指标(手术时间、术中出血量、下床时间、住院时间)、疼痛数字评分量表(NRS)评分、脊髓神经功能及术后并发症。结果研究组治疗总有效率为90.91%(30/33),对照组为69.70%(23/33),差异有统计学意义(P<0.05)。两组手术时间比较,差异未见统计学意义(P>0.05);研究组下床时间、住院时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。术后2周,研究组NRS评分低于对照组,差异有统计学意义(P<0.05);术后3、6个月,两组NRS评分比较,差异未见统计学意义(P>0.05)。研究组脊髓神经功能分级优于对照组,术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论与全椎板切开脊髓外硬膜下肿瘤切除术比较,半椎板切开脊髓外硬膜下肿瘤切除术能够提高治疗效果,减少术中出血量,加快术后恢复,减轻疼痛,改善脊髓神经功能,减少并发症的发生。

Objective To compare the application value of total laminotmoy and hemilaminotomy in the resection of extraspinal subdural tumors.Methods A total of 66 patients who underwent extraspinal subdural tumor resection in Zhoukou Central Hospital from September 2021 to September 2023 were selected as the study objects.They were divided into study group and control group according to random number table method,with 33 cases in each group.The control group was treated with total laminotmoy,and the study group was treated with hemilaminotomy.The clinical effects,surgical indexes(operation time,intraoperative blood loss,time of getting out of bed,duration of staying in hospital),digital pain scale(NRS)score,spinal nerve function and postoperative complications were compared between the two groups.Results The total effective rate in the control group was 69.70%(23/33),and the total effective rate of the study group was 90.91%(30/33),the difference was significant(P<0.05).There was no significant difference in operation time between the two groups(P>0.05).Compared with the control group,the study group had shorter time of getting out of bed and staying in hospital,and less intraoperative blood loss(P<0.05).Two weeks after operation,the NRS score of the study group was lower than that of the control group(P<0.05).At 3 and 6 months after operation,there was no significant difference in NRS scores between the two groups(P>0.05).The spinal nerve function of the study group was better than that of the control group(P<0.05).Compared with the control group,the incidence of postoperative complications was lower in the study group(P<0.05).Conclusions Compared with total laminotomy spinal subdural tumor resection,hemilaminotomy spinal subdural tumor resection can improve the therapeutic efficacy,reduce intraoperative hemorrhage,accelerate the postoperative recovery,and reduce pain,improve the spinal nerve function,and reduce the occurrence of complications.