开窗术式治疗腰椎间盘突出症的临床观察

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1、湖北中医学院硕士学位论文开窗术式治疗腰椎间盘突出症的临床观察姓名：张军波申请学位级别：硕士专业：中西结合临床骨科指导教师：竺义亮2003.6.1致谢衷心感谢导簿竺义亮裁圭程基簿袁零文憋遥题、设诗、蕊察、统诗彝撰鬈避程中酶瓣心稽簿，及婚臻实霹辩阉对我蘸索壤美翻=。衷心麟谢省中医酣航踩建锋副主强瞻师、何承遄剐盘任医师、尹晓光主治医辫及嚣秘24瘸送所鸯辍护人嚣丧戆臻实磊孛缭我鼹关心参帮黠。衷心感谶盛汉市672医院聂中牮主任、姜学硗副主经嚣薄、蕾堂才辩主任隧师、甘学灾主滚医师放其他瞻护人掇在临床实习中给我的帮助。特别感谢磺究生邦各位老薄给寂姆关心。感落臀傍98缓陈雾蘸学帮赫竞戒诧文

2、戆蠢窜工捧。感谢掰霜关心、牵挂戏的阉学、髑发。中文摘要强螅：为了充分说明腰椎阆盘突出症椎板间开窗术式的傥点，对开窗术，半椎板絮狳、全撼援翻狳穗接攮滁三本式拧皴遗褥比较。方法：任意抽取行开窗术武300例，半椎板切除者40例，全椎板切除30例，所褰瘸攥均采阕电谬咨谗黟门诊复查，随诊3翼至2警。三臻在性别，年龄，病程，症状及突出部位笼显著性差异，具有可比性。对量组术中切口太小，所用时问，出血羹，本螽瓣康砖蝴，并发疰及裁捩改繁方疆避圣亍比较。结粜：三术式问的疗效羞异具有显著能，三组患者妻观感觉优良率分另4为97％、84％、17％。舞鹫组疗效最好，窀具袁切口小，窭血少，本孛辑罔酵阙短

3、，本后并发疰少，患者康复快。而全椎板切除组疗效最差，且术后粘连机会多。芈椎檄切除介于嚣者之闻“夕。+’／。’结论：半椎板、全椎板切除术严藿破坏了腰椎手术节段三维稳定性，且暴露范围大，出血多，费对长，磺膜囊及{孛经摄牯连规会多。撼援翊潜爨死密对腰椎稳定结撼破坏少，暴露范围小，出血少，术后疤痕粘连及聪源性椎管狭窄机会少。所I；之，在椎闻盎突出痘筝术治疗上应苔选开蜜术。主题词：腰椎问盘突出癍；、爱菊术后并发症。?objective：ABSTRACTToanalysethesuperiorityofthefenestrationlumbardisceetomybycomparing

4、theresultsofthreedifferentsurgicalapproachesfortreatmentoflumbardischemiation．Methods：Three-hundredandseventypatientsundergoneoperativetreatmentforlumbardischerniationwerereviewed．GroupAconsistedof3秘casesweredonethroughfenestation．GroupBof40casesweredonethroughsemi-iaminectomy,andgroupCof3

5、0CaSesthroughtotal-laminectomy．AUeAtseswerefellowed-upfromthreemonthestotwoyears。ThereWaSnosignificantdimFencebetweenthreegroupsinsex，age，symptomsandsignsbeforeoperation。Lengthofcuts,thebloodloss，theoperationtime,thepost-operationhospitalstaytime，complicationsandthepost-operatlveresultsWer

6、esurveyed．Resuits：Thereweresignificantdifferenceinallindkesbetweenthleegroups．Theexcellentandgoodrateof97％，酣‰17％respectivelyinthegroupsA，B’C。ThefenestationlumbardisceetomyhadthebestoutcomeandtheleaStcomplications．Whrealsthetohi-Iamineetamydisceetomybore恤eworstoutcomeandthefrequentlyencount

7、eredcomplicationssuch髓intabilityduracomplications，andetes．Conclusions：ThefenestationlumbardiscectomyshowslesstraumaandfaSterrecovery．Itissafeandeffectivein懒etroatmentofinmberdischeniation．Subj忧twords：LumbardischeniationOperatePostoperativecomplications3·综述·腰椎间