退行性腰椎管狭窄症手术方式选择及疗效分析.docVIP

退行性腰椎管狭窄症手术方式选择及疗效分析 　　[摘要] 目的 分析退行性腰椎管狭窄症的手术方式选择及临床治疗效果。方法 随机选取2014年1月―2015年12月该院收治的60例退行性腰椎管狭窄症患者临床资料，根据患者身体实际情况选择不同的手术方式，把60例患者分成两组，第一组应用椎板切除减压术，第二组应用椎板切除合并植骨融合内固定术，各30例。比较两组患者临床治疗效果、生活质量改善情况。结果 手术治疗后，两组Oswestry功能指数（ODI）评分、生活质量评分对比差异显著；第一组手术时间（80.5±9.9）min，出血量（109.6±9.8）mL，发生并发症8例；第二组手术时间（145.5±20.5）min，出血量（395.2±25.5）mL，发生并发症3例；两种患者手术时间、术中出血量、不良反应、术后并发症等对比差异有统计学意义（P0.05）。结论 退行性腰椎管狭窄症选择椎板切除减压术临床治疗效果较为理想，不过，当患者出现重度狭窄或预估患者术后会有脊柱不稳定时，选择椎板切除合并植骨融合内固定术治疗效果更佳，值得推广应用。 　　[关键词] 退行性腰椎管狭窄症；手术方式；疗效 　　[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2016）05（c）-0032-03 　　[Abstract] Objective To analyze the selection of operative method and clinical treatment effect of degenerative lumbar stenosis. Methods 60 cases of patients with degenerative lumbar stenosis admitted and treated in our hospital from January 2014 to December 2015 were randomly selected and divided into two groups with 30 cases in each according to the different operative methods selected by the patients with different physical conditions， the first group were treated with laminectomy and decompression， the second group were treated with laminectomy and iliac bone graft fusion and internal fixation， and the clinical treatment effect and improvement of quality of life were compared between the two groups. Results After operation treatment， the differences in the Oswestry function index score and quality of life score between the two groups were obvious， the operation time， blood loss， occurrence cases of complications were respectively（80.5±9.9） min，（109.6±9.8） mL and 8 cases in the first group and （145.5±20.5） min， （395.2±25.5） mL and 3 cases in the second group， and the differences in the operation time， intraoperative blood loss， adverse reactions and postoperative complications between the two groups were obvious by comparison（P0.05）. Conclusion The effect of laminectomy and decompression in treatment of degenerative lumbar stenosis is ideal， however， the treatment effect of the laminectomy and iliac bone graft fu