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

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1、2018-03-2910:29:48中国现代医生2018年5期朱绍琼王世鑫杨家林范星华黎清交张法慈张四清［摘要］戸的觀察腰椎管狭窄症的老年患者采用经皮椎间孔镜技术治疗的临床疗效。方法选择我院2016年1月〜2017年笛月收治的腰椎管狭窄并择期手术的老年患者60例，釆用随机数字表法将其分成经皮组与常规组，每组30例。经皮组釆用经皮椎间孔镜髓核摘除+黄韧带部分切除术，常规组采用传统开放手术减压并后路椎体间融合术。比较两组患者手术悄况(切口长度、手术时间、术中出血量、术后疼痛VAS评分、住院天数、腰椎活动度)与临床效果。结果经皮组在切口长度、手术时间、术屮出血量、腰部疼痛VAS评分、住院天数、

2、腰椎活动度相比明显优于常规组，差异具有统计学意义(P<0.01)o两组术后下肢痛VAS评分比较，差异无统计学意义(P>0.05)。经皮组临床疗效显著率为96.67%,常规组为73.33%,两组差异具有统计学意义(P<0.05)。结论对于老年腰椎管狭窄症的老年患者，采用经皮椎间孔镜技术治疗，与常规开放手术比较，可减少手术对机体产牛•的机械性创伤，进而缩短恢复时间，降低腰部疼痛情况，改善腰椎活动度，有效改善临床症状，效果理想，值得临床推广。［关键词］经皮椎间孔镜；老年人；腰椎管狭窄症；腰椎活动度［中图分类号］R687.3［文献标识码］B［文章编1673-9701(2018)05-0069-0

3、3［Abstract］ObjectiveToobserveandanalyzetheclinicaleffectsofpercutaneoustransforaminalendoscopicultrasonographyinelderlypatientswithlumbarspinalstenosis.MethodsAtotalof60elderlypatientswithlumbarspinalstenosisundergoingselectivesurgeryinourhospital(January2016toNovember2017)wererandomlydividedinto

4、percutaneousgroupandroutinegroupaccordingtotherandomnumbertable,with30casesineachgroup.Percutaneousgroupwasgivenremovalofnucleuspulposusunderpercutaneoustransforaminalendoscopy+partialligamentumflavumexcision.Theroutinegroupwasgiventraditionalopensurgerydecompressioncombinedwithposteriorlumbarint

5、erbodyfusion.Thesurgicalconditions(incisionlength,operationtime,intraoperativebloodloss,postoperativepainVASscore,lengthofstay,andlumbaractivity)andclinicalefficacywerecompared・ResultsThelengthofsurgicalincision,operationtime,intraoperativebloodloss,lumbarpainVASscore,lengthofhospitalstay,andlumb

6、aractivityinthepercutaneousgroupweresignificantlybetterthanthoseintheroutinegroup,andthedifferenceswerestatisticallysignificant(P<0.01).VASscoreofpostoperativelowerlimbpainwascomparedbetweenthetwogroups>andthediffereneewasnotstatisticallysignificant(P>0.05)・Theclinicaleffectinthepercutaneousgroup

7、was96.67%,andwas73.33%intheroutinegroup・Thediffereneewasstatisticallysignificant(P<0.05)・ConclusionForelderlypatientswithlumbarspinalstenosis,theapplicationofpercutaneoustransforaminalendoscopy,comparedwiththeroutineop