[1]桂凯红,张海燕,黄　林,等.微创单侧入路双侧减压固定与开放双侧减压固定治疗单间隙腰椎管狭窄症疗效比较[J].新乡医学院学报,2017,34(3):228-230.[doi:10.7683/xxyxyxb.2017.03.019]
　GUI Kai-hong,ZHANG Hai-yan,HUANG Lin,et al.Comparison of effect of minimally invasive bilateral decompression fixation via unilateral approach and open bilateral decompression fixation in the treatment of single level lumbar spinal stenosis[J].Journal of Xinxiang Medical University,2017,34(3):228-230.[doi:10.7683/xxyxyxb.2017.03.019]
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微创单侧入路双侧减压固定与开放双侧减压固定治疗单间隙腰椎管狭窄症疗效比较
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
34
期数:
2017年3
页码:
228-230
栏目:
临床研究
出版日期:
2017-03-05

文章信息/Info

Title:
Comparison of effect of minimally invasive bilateral decompression fixation via unilateral approach and open bilateral decompression fixation in the treatment of single level lumbar spinal stenosis
作者:
桂凯红1; 张海燕2; 黄　林1; 周　旺1
（1.黄冈市中心医院骨科，湖北　黄冈　438000；2.黄州区人民医院医保科，湖北　黄冈　436100）
Author(s):
GUI Kai-hong1; ZHANG Hai-yan2; HUANG Lin1; ZHOU Wang1
（1.Department of Orthopedics，Huanggang Central Hospital，Huanggang 438000，Hubei Province，China；2.Department of Medical Insurance，Huangzhou District People′s Hospital，Huanggang 436100，Hubei Province，China）
关键词:
微创手术; 开放手术; 腰椎管狭窄症
Keywords:
minimally invasive surgery; open surgery; lumbar spinal stenosis
分类号:
R687.3
DOI:
10.7683/xxyxyxb.2017.03.019
文献标志码:
A
摘要:
目的　比较微创单侧入路双侧减压固定与开放双侧减压固定治疗单间隙腰椎管狭窄症的临床疗效，为临床选择腰椎管狭窄症的治疗方法提供参考。方法　选取2013年6月至2015年6月黄冈市中心医院收治的单间隙腰椎管狭窄症患者90例，根据治疗方法分为微创手术组和开放手术组，每组45例。微创手术组患者给予微创单侧入路双侧减压固定治疗，开放手术组患者给予开放双侧减压固定治疗，对2组患者的手术时间、术中出血量、住院时间、术前及术后1 a腰部疼痛Oswestry功能障碍指数（ODI）评分和视觉模拟评分法（VAS）评分进行比较。结果　开放手术组患者的手术时间、术中出血量和住院时间分别为（96.59±10.21）min、（187.79±15.35）mL、（8.89±0.87）d，微创手术组患者的手术时间、术中出血量和住院时间分别为（75.35±8.42）min、（103.41±23.18）mL、（6.35±1.05）d，微创手术组患者的手术时间和住院时间显著短于开放手术组（P<0.05），术中出血量显著少于开放手术组（P<0.05）。术前，开放手术组患者腰部疼痛ODI评分和VAS评分分别为65.23±8.85、6.23±0.09，微创手术组患者腰部疼痛ODI评分和VAS评分分别为65.24±8.96、6.24±0.15，2组比较差异均无统计学意义（P>0.05）。术后1 a，开放手术组患者腰部疼痛ODI评分和VAS评分分别为26.68±6.03、2.16±0.21，微创手术组患者腰部疼痛ODI评分和VAS评分分别为25.38±7.78、2.12±0.08，2组患者术后1 a腰部疼痛ODI评分及VAS评分均显著低于术前（P<0.05），2组患者术后1 a 腰部疼痛ODI评分及VAS评分比较差异均无统计学意义（P>0.05）。结论　微创单侧入路双侧减压固定与开放双侧减压固定治疗单间隙腰椎管狭窄症效果相当，但微创单侧入路双侧减压固定术创伤小，手术时间短，术中出血量少，有利于患者康复。
Abstract:
Objective　To compare the effect of minimally invasive bilateral decompression fixation via unilateral approach and open bilateral decompression fixation in the treatment of single level lumbar spinal stenosis，and provide reference for clinical selection of treatment method of lumbar spinal stenosis.Methods　Ninety patients with single level lumbar spinal stenosis were selected from June 2013 to June 2015 in Huanggang Central Hospital.The patients were divided into minimally invasive surgery group and open surgery group according to the treatment methods，forty-five patients in each group.The patients in minimally invasive surgery group were treated with minimally invasive bilateral decompression fixation via unilateral approach，and the patients in open surgery group were treated with open bilateral decompression fixation.The operation time，intraoperative blood loss，hospitalization time，the scores of Oswestry disability index（ODI） and visual analogue scales（VAS） of lumbago before and one year after treatment were compared between the two groups.Results　The operation time，intraoperative blood loss and hospitalization time in the open surgery group was （96.59±10.21）min，（187.79±15.35）mL and （8.89±0.87）d，respectively；and the operation time，intraoperative blood loss and hospitalization time in the minimally invasive surgery group was （75.35±8.42）min，（103.41±23.18）mL and （6.35±1.05）d，respectively.The operation time and hospitalization time in the minimally invasive surgery group were significantly shorter（P<0.05） than those in the open surgery group （P<0.05），and the intraoperative blood loss in minimally invasive surgery group was significantly less than that in open surgery group （P<0.05）.The preoperative ODI score and VAS score of lumbago in the open surgery group was 65.23±8.85 and 6.23±0.09，respectively；the preoperative ODI score and VAS score of lumbago in the minimally invasive surgery group was 65.24±8.96 and 6.24±0.15，respectively；there was no significant difference between the two groups （P>0.05）.One year after operation，the ODI score and VAS score of lumbago in the open surgery group was 26.68±6.03 and 2.16±0.21，respectively；the ODI score and VAS score of lumbago in the minimally invasive surgery group was 25.38±7.78 and 2.12±0.08，respectively.The ODI score and VAS score of lumbago at the time point of one year after operation were significantly lower than those before operation（P<0.05），but there was no significant difference in the ODI score and VAS score between the two groups at the time point of one year after operation （P>0.05）.Conclusion　The effect of minimally invasive bilateral decompression fixation via unilateral approach and open bilateral decompression fixation in the treatment of single level lumbar spinal stenosis is similar.But the minimally invasive bilateral decompression fixation has the advantages of less wound，shorter operation time，less intraoperative blood loss and faster postoperative recovery.

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更新日期/Last Update: 2017-03-05