摘要
目的探讨Quadrant微创疗法治疗腰椎间盘突出症的临床疗效及安全性,为临床治疗该病提供参考。方法以54例腰椎间盘突出症患者为研究对象,均符合Quadrant微创术及常规腰椎椎体间融合术的相关指征。将患者随机分为2组,常规组27例行经椎间孔腰椎椎体间融合术(TLIF)治疗,微创组27例行Quadrant微创术治疗,观察2组手术各指标情况及术后12个月临床疗效。结果微创组术中出血量、术后切口引流量、镇痛药物用量均明显少于常规组(P均<0.05),下床时间、住院时间均明显短于常规组(P均<0.05),手术时间、术中射线面积剂量、射线暴露时间、患者皮肤入射剂量均明显高于常规组(P均<0.05);2组术后3 d视觉疼痛模拟评分和术后12个月Oswestry功能障碍指数均明显低于术前,且微创组各项评分均明显低于常规组(P均<0.05);微创组术后1,3,5 d肌酸激酶水平均明显低于常规组(P均<0.05),且围手术期并发症发生率明显低于常规组(P<0.05)。2组治疗优良率比较差异无统计学意义(P>0.05)。结论 Quadrant微创疗法治疗腰椎间盘突出症与常规TLIF术比较出血量和围手术期并发症较少,创伤小,术后疼痛较轻,住院时间短,疗效显著且安全,值得临床推广应用。
Objective It is to study the clinical efficacy and safety of Quadrant minimally invasive treatment for lumbar disc herniation,and to provide better evidences for the treatment. Methods 54 cases of lumbar disc herniation who were accord with the indications of Quadrant minimally invasive surgery and routine lumbar interbody fusion were selected as the research objects,and were randomly divided into 2 groups,routine group（ 27 cases） treated with traditional transforaminal lumbar interbody fusion（ TLIF）,minimally invasive group（ 27 cases） treated with Quadrant minimally invasive surgery. The clinical efficacy in 12 months after surgery and the changes of each index were compared between the 2 groups. Results The volume of bleeding during operation,postoperative wound drainage,analgesic dosage were significantly less,ambulation time,hospitalization time were shorter,operation time,operation time under X-ray were longer,X ray area and dose during operation and X ray dose from skin were more in minimally invasive group than that in routine group（ P〈0. 05）. The postoperative visual analogue scale（ VAS） in 3 days after operation and Oswestry disability index（ ODI） in 12 months after operation were lower than that before operation in both groups（ P〈0. 05）,and the scores and index in minimally invasive group were lower than that in routine group（ P〈0. 05）. The levels of creatine kinase in 1,3,5 days after operation and incidence rate during preoperative and postoperative period were lower in minimally invasive group than that in routine group（ P〈0. 05）. There was no significant difference in excellent rate between the two groups（ P〉0. 05）. Conclusion Compared with conventional TLIF,Quadrant minimally invasive therapy had less bleeding volume and complications,less postoperative pain,less injury,shorter hospitalization time,the curative effect is remarkable and safe,and it is worthy of widely popularization and application.
出处
《现代中西医结合杂志》
CAS
2017年第7期701-703,707,共4页
Modern Journal of Integrated Traditional Chinese and Western Medicine
