摘要
目的通过与常规后路开窗髓核摘除术治疗腰椎间盘突出症比较,判断运用可扩张通道管系统(X-Tube)行腰椎后路微创椎间盘髓核摘除术的临床价值。
方法对从2009年5月至2010年2月在我院行X-Tube辅助下腰椎后路微创椎间盘髓核摘除术的12例腰椎间盘突出症患者进行回顾性分析,记录手术时间、术中出血量、术后住院天数、术前术后血红蛋白丢失比及白蛋白丢失比,并与同期在我院行常规后路开窗髓核摘除术的12例患者进行对比。对所有24例病患进行定期随访,按Nakai标准评判手术疗效并记录术后并发症的发生情况。
结果微创组及常规组的手术优良率均为91.7%,两组间无明显统计学差异(P>0.05)。微创组平均手术时间、术中出血量、术后住院天数、术前术后血红蛋白丢失比及白蛋白丢失比分别为：57.83±9.92分钟,55.00±9.04毫升,5.67±1.23天,9.07±2.62%及9.59±2.62%；而常规组分别为：67.00±10.77分钟,85.42±8.65毫升,8.50±1.88天,13.96±4.87%及14.92±5.57%。该5项指标两组间均有统计学差异(P<0.05)。
结论X-Tube辅助下腰椎后路椎间盘髓核摘除术治疗腰椎间盘突出症具有创伤小、手术时间短、术中失血少、术后住院天数少、术后患者恢复快等特点。
Objective To evaluate the clinical value of minimally invasive posterior lumbar discectomy assisted with X-Tube system in the treament of lumbar disc herniation comparing with traditional open posterior lumbar discectomy.
Methods Retrospective analysis of 12 patients who accepeted minimally invasive posterior lumbar discectomy assisted with X-Tube system during May 2009 to February 2010. The operative duration, blood loss, hospitalization days after operation, the loss rate of haematoglobin and albumin were evaluated in our study. Meanwile, we took 12 lumbar disc herniation patients who accepcted traditinal open posterior lumbar discectomy as the control group during the same time. Regular follow-up was carried out for these 24 patients to record postoperative complications, and the therapeutic effect was evaluated with the Nakai standard.
Results There was no significant difference between the minimally invasive group and the traditional open group in the aspect of operation fineness rate which were both 91.7%. The operative duration, blood loss, hospitalization days after operation, the loss rate of haematoglobin and albumin of the minimally invasive group were 57.83±9.92 min,55.00±9.04 ml,5.67±1.23 days,9.07±2.62%and 9.59±2.62%respectively. And the five indexes in the traditional open group were 67.00±10.77 min,85.42±8.65 ml, 8.50±1.88 days,13.96±4.87%and 14.92±5.57%respectively. Significant differences were exist in the above five indexes between the two groups(P< 0.05).
Conlusion Minimally invasive posterior lumbar discectomy assisted by X-Tube system minimize tissue trauma and blood loss, shorten the operation duration and hospitalization time, the short-term therapeutic effects are quite good.
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