| 刘鹏军,韩 康,杨智泉,刘宏伟,周 勇,李卫勤.多节段腰椎间盘突出症的责任节段治疗与整体治疗的临床疗效比较[J].,2017,17(9):1743-1746 |
| 多节段腰椎间盘突出症的责任节段治疗与整体治疗的临床疗效比较 |
| Comparison of the Clinical Efficacy of Different Depressing Segments in the Treatment of Herniation of Multi-segmented Lumber Intervertebral Disc |
| 投稿时间：2016-08-21 修订日期：2016-09-20 |
| DOI：10.13241/j.cnki.pmb.2017.09.039 |
| 中文关键词: 腰椎间盘突出症 髓核摘除 减压 多节段 |
| 英文关键词: Lumbar disc herniation Diseetomy Decompression Multi-Segmental |
| 基金项目:国家自然科学基金项目(81272441)；济南军区总医院院长基金项目(2015ZX01) |
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| 中文摘要: |
| 摘要 目的：研究和比较不同的治疗方式（责任节段治疗与整体治疗）治疗多节段腰椎间盘突出症（Herniation of Mutisegmented Lumber Intervertebral Disc，HMLD）的临床疗效及安全性。方法：对2010.01年至2013.01在我科明确诊断为多节段腰椎间盘突出且行手术治疗的共计78例患者进行回顾性分析。按照治疗方式的不同分为责任节段组（实验组，42例）和整体治疗组（对照组，36例）。结合手术前后的随访资料，评价并比较两组患者的疼痛模拟评分(VAS)、JOA 功能评分及围手术期的手术时间、术中出血量、术后下地时间，花费，并发症等指标。结果：实验结果显示，实验组与对照组在术后6月，12月及36月的VAS疼痛评分及JOA评分的比较中并无显著性差异（P>0.05）。但术后第二日实验组患者的疼痛程度显著好于对照组（P<0.05）。实验组的术中出血量、花费及下地时间显著优于对照组（P<0.05）。在并发症方面，术后1年内，实验组的并发症发生率显著优于对照组（P<0.05）；术后1年后，对照组的发生率较好，但两组间均无统计学差异（P>0.05）。结论：对于多节段椎间盘突出症，找到责任节段并针对责任节段进行治疗较整体治疗来讲，能够在取得相似治疗效果和安全性的同时，能够有效的减少花费，手术创伤及术后疼痛指标，并能有效减少短期并发症的发生。在多节段腰椎间盘突出症的治疗中可以作为一种推荐的手术术式。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the clinical effect and safety of different depressing segments（responsible segment or total seg- ments） in the treatment of herniation of Multi-segmented lumber intervertebral disc, HMLD. Methods: 78 cases of patients with hernia- tion of Multi-segmented lumber intervertebral disc treated from 2010.01 to 2013.01 were retrospectively reviewed, in which 42 patients were treated by only responsible segment and 36 patients were treated by total segments. The clinical outcomes were evaluated and com- pared by lost, operation time, blood loss, postoperative hospital stay and intraoperative complications. The surgical results were evaluated according to the Visual Analogue Scale(VAS) and Japanese Orthopedic Association(JOA). Results: There was no significant difference between the two groups(experiment group and total segments) in the VAS score and JOA in 6, 12 and 36 months after the operation(P>0.05). However, the VAS was significant better in experiment group on the day after the operation(P<0.05). The blood lost, money lost and the stay time in experiment group were significant better than that in control group(P<0.05); The complication incidence in experiment group was significant better than that in control group in the first year after the operation. One yaras later, the complication incidence in control group was less, however, there was no significant difference between the two groups(P>0.05). Conclusion: For the treatment of herniation of Multi-segmented lumber intervertebral disc, finding the responsible segment and treating could have the similar clinical effi- cacy compairing with the total segments depressing, which could have the less lost,operation trauma and the short-term complication. This treatment could be further recommended clinically. |
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