经皮椎间孔镜技术治疗腰椎管狭窄症合并骨质疏松症患者的疗效和安全性分析
|
摘要
目的探讨经皮椎间孔镜技术治疗腰椎管狭窄症合并骨质疏松症患者的疗效和安全性。方法选取2016年2月至2018年2月我院骨科治疗腰椎管狭窄症合并骨质疏松症患者78例为研究主体,按照治疗方案的不同分为对照组(32例)与观察组(46例),对照组采取传统开放手术治疗,观察组采取经皮锥间孔镜治疗方案。观察两组手术时间、手术出血量与卧床恢复时间,比较两组手术前与术后3个月疼痛评分(VAS评分)与Oswestry功能障碍指数问卷(ODI评分)以及治疗效果。结果观察组在手术时间(92±12)、术中出血量(37±10)、卧床(8.1±1.2)优于对照组(127±10)、(59±14)、(13.9±1.8),组间差异均有统计学意义(P<0.05);观察组术后VAS评分(2.3±0.5)、ODI(20.7±5.7)指数评分显著优于对照组(3.2±0.7)、(32.4±6.9),组间差异均有统计学意义(P<0.05);两组总有效率分别为95.65%、87.50%,且观察组总有效率优于对照组(P<0.05)结论临床中治疗腰椎管狭窄症伴骨质疏松给予经皮锥间孔镜治疗后发现,治疗效果较佳,且无并发症。
Objective To evaluate the efficacy and safety of percutaneous transforaminal technique in the treatment of patients with lumbar spinal stenosis complicated with osteoporosis.Methods From February 2016 to February 2018,78 patients with lumbar spinal stenosis and osteoporosis were treated as our main subjects.According to the treatment plan,they were divided into control group(32 cases)and observation group(46).For example,the control group received a conventional treatment plan,and the observation group underwent a percutaneous transforaminal treatment.The operation time,surgical bleeding volume and bed rest time were observed.The pain scores(VAS score)and Oswestry dysfunction index questionnaire(ODI score)and treatment effects were compared before and 3 months after operation.Results The operation time,intraoperative blood loss and bed rest time in the observation group were significantly better than those in the control group,and the difference between the groups was significant(P<0.05).The VAS score and ODI index score of the observation group were significantly better than the control group,and the difference between the groups was significant.(P<0.05);the total effective rate was 95.65% and 87.50%,respectively,and the total effective rate of the observation group was significantly better than that of the control group(P<0.05).Conclusion Clinical treatment of lumbar spinal stenosis with osteoporosis After the treatment of the cone-cone mirror,the treatment effect was better and there was no complication.
Objective To evaluate the efficacy and safety of percutaneous transforaminal technique in the treatment of patients with lumbar spinal stenosis complicated with osteoporosis.Methods From February 2016 to February 2018,78 patients with lumbar spinal stenosis and osteoporosis were treated as our main subjects.According to the treatment plan,they were divided into control group(32 cases)and observation group(46).For example,the control group received a conventional treatment plan,and the observation group underwent a percutaneous transforaminal treatment.The operation time,surgical bleeding volume and bed rest time were observed.The pain scores(VAS score)and Oswestry dysfunction index questionnaire(ODI score)and treatment effects were compared before and 3 months after operation.Results The operation time,intraoperative blood loss and bed rest time in the observation group were significantly better than those in the control group,and the difference between the groups was significant(P<0.05).The VAS score and ODI index score of the observation group were significantly better than the control group,and the difference between the groups was significant.(P<0.05);the total effective rate was 95.65% and 87.50%,respectively,and the total effective rate of the observation group was significantly better than that of the control group(P<0.05).Conclusion Clinical treatment of lumbar spinal stenosis with osteoporosis After the treatment of the cone-cone mirror,the treatment effect was better and there was no complication.
引文
[1] 王小明,王亮,夏斌,等.经皮椎间孔镜治疗腰椎管狭窄症伴骨质疏松的有效性和安全性分析[J].中国医药导报,2016,13(11):121-124.
[2] 范智芳.经皮椎间孔镜技术治疗退变性腰椎管狭窄症疗效及安全性分析[J].中国实用医药,2016,11(22):58-59.
[3] 宋晓磊,王红建,李灏,等.椎间孔镜BEIS技术治疗老年患者腰椎管狭窄症疗效研究[J].实用骨科杂志,2016,22(3):251-254.
[4] 赵一民,汤玮,王振东,等.经皮椎间孔镜技术治疗腰椎管狭窄症的早期临床疗效分析[J].中国矫形外科杂志,2016,24(19):1745-1748.
[5] 华强,赵慧毅,胡治平.经皮椎间孔镜治疗老年性腰椎管狭窄症的临床疗效分析[J].中国矫形外科杂志,2016,24(3):278-280.
[6] Pan Z,Ha Y,Yi S,et al.Efficacy of Transforaminal Endoscopic Spine System(TESSYS)Technique in Treating Lumbar Disc Herniation[J].Medical Science Monitor International Medical Journal of Experimental & Clinical Research,2016,22(2):530-539.
[7] Zhou Y L,Chen G,Bi D C,et al.Short-term clinical efficacy of percutaneous transforaminal endoscopic discectomy in treating young patients with lumbar disc herniation.[J].Journal of Orthopaedic Surgery & Research,2018,13(1):61.
[8] Finitsis D J,Pellowski J A,Huedomedina T B,et al.Visual analogue scale(VAS)measurement of antiretroviral adherence in people living with HIV(PLWH):a meta-analysis.[J].Journal of Behavioral Medicine,2016,39(6):1043-1055.
[9] 裴博.经皮椎间孔镜技术与传统手术在治疗老老年腰椎管狭窄症中的疗效对比[J].临床医药文献电子杂志,2016,3(11):2035-2035.
[10] Duan WR,Yue HU,Teng-Fei QI,et al.The therapeutic effect of percutaneous transforaminal endoscopic discectomy through interlaminar approach for treating lumbar disc herniation[J].Chinese Journal of Contemporary Neurology & Neurosurgery,2016,16(4):204-209.
[11] 刘维,吴青杰.经皮椎间孔镜治疗老年性腰椎管狭窄症的临床疗效分析[J].中国现代药物应用,2017,11(13):88-89.
[12] Wang Y,Zhang W,An J,et al.Evaluation of Transforaminal Endoscopic Discectomy in Treatment of Obese Patients with Lumbar Disc Herniation[J].Medical Science Monitor International Medical Journal of Experimental & Clinical Research,2016,22:2513-2519.
[13] 朱绍琼,王世鑫,杨家林,等.经皮椎间孔镜技术治疗老年人腰椎椎管狭窄症的临床疗效观察[J].中国现代医生,2018(5):69-71.
[14] Uniyal P,Choi G,Khedkkar B.Percutaneous Transpedicular Lumbar Endoscopy:A Case Report[J].International Journal of Spine Surgery,2016,10:31.
[15] 董庆鹏,李圣洪,王云霞,等.经皮椎间孔镜治疗老年性腰椎管狭窄症患者的疗效[J].实用疼痛学杂志,2017,13(5):328-331.
[2] 范智芳.经皮椎间孔镜技术治疗退变性腰椎管狭窄症疗效及安全性分析[J].中国实用医药,2016,11(22):58-59.
[3] 宋晓磊,王红建,李灏,等.椎间孔镜BEIS技术治疗老年患者腰椎管狭窄症疗效研究[J].实用骨科杂志,2016,22(3):251-254.
[4] 赵一民,汤玮,王振东,等.经皮椎间孔镜技术治疗腰椎管狭窄症的早期临床疗效分析[J].中国矫形外科杂志,2016,24(19):1745-1748.
[5] 华强,赵慧毅,胡治平.经皮椎间孔镜治疗老年性腰椎管狭窄症的临床疗效分析[J].中国矫形外科杂志,2016,24(3):278-280.
[6] Pan Z,Ha Y,Yi S,et al.Efficacy of Transforaminal Endoscopic Spine System(TESSYS)Technique in Treating Lumbar Disc Herniation[J].Medical Science Monitor International Medical Journal of Experimental & Clinical Research,2016,22(2):530-539.
[7] Zhou Y L,Chen G,Bi D C,et al.Short-term clinical efficacy of percutaneous transforaminal endoscopic discectomy in treating young patients with lumbar disc herniation.[J].Journal of Orthopaedic Surgery & Research,2018,13(1):61.
[8] Finitsis D J,Pellowski J A,Huedomedina T B,et al.Visual analogue scale(VAS)measurement of antiretroviral adherence in people living with HIV(PLWH):a meta-analysis.[J].Journal of Behavioral Medicine,2016,39(6):1043-1055.
[9] 裴博.经皮椎间孔镜技术与传统手术在治疗老老年腰椎管狭窄症中的疗效对比[J].临床医药文献电子杂志,2016,3(11):2035-2035.
[10] Duan WR,Yue HU,Teng-Fei QI,et al.The therapeutic effect of percutaneous transforaminal endoscopic discectomy through interlaminar approach for treating lumbar disc herniation[J].Chinese Journal of Contemporary Neurology & Neurosurgery,2016,16(4):204-209.
[11] 刘维,吴青杰.经皮椎间孔镜治疗老年性腰椎管狭窄症的临床疗效分析[J].中国现代药物应用,2017,11(13):88-89.
[12] Wang Y,Zhang W,An J,et al.Evaluation of Transforaminal Endoscopic Discectomy in Treatment of Obese Patients with Lumbar Disc Herniation[J].Medical Science Monitor International Medical Journal of Experimental & Clinical Research,2016,22:2513-2519.
[13] 朱绍琼,王世鑫,杨家林,等.经皮椎间孔镜技术治疗老年人腰椎椎管狭窄症的临床疗效观察[J].中国现代医生,2018(5):69-71.
[14] Uniyal P,Choi G,Khedkkar B.Percutaneous Transpedicular Lumbar Endoscopy:A Case Report[J].International Journal of Spine Surgery,2016,10:31.
[15] 董庆鹏,李圣洪,王云霞,等.经皮椎间孔镜治疗老年性腰椎管狭窄症患者的疗效[J].实用疼痛学杂志,2017,13(5):328-331.