[1]肖正军 王丽芬 陈吉祥 李玉琴 谢朝晖△.经皮椎间孔镜手术治疗腰椎间盘突出症319例[J].中国中医骨伤科杂志,2019,27(10):63-65.
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经皮椎间孔镜手术治疗腰椎间盘突出症319例()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第27卷
期数:
2019年10期
页码:
63-65
栏目:
临床报道
出版日期:
2019-10-10

文章信息/Info

文章编号:
1005-0205(2019)10-0063-03
作者:
肖正军1 王丽芬1 陈吉祥1 李玉琴1 谢朝晖1△
1兰州大学第一医院(兰州,730000)
关键词:
腰椎间盘突出症 椎间孔镜 脊柱微创
分类号:
R681.5
文献标志码:
B
摘要:
目的:探讨经皮椎间孔镜手术治疗腰椎间盘突出症的手术方式、临床疗效、手术安全性及手术并发症的防治。方法:回顾性分析2014年11月至2018年1月本科收治住院的319例腰椎间盘突出症患者,其中男178例,年龄39~89岁,平均54岁; 女141例,年龄43~82岁,平均47岁。手术方式均采用TESSYS技术,观察手术时间,术中出血量和住院时间,术中和术后并发症。视觉模拟评分(VAS)方法评估手术前后患者腰腿痛情况,改良MacNab评分评估患者术后腰腿功能恢复情况。 结果:TESSYS技术治疗319例腰椎间盘突出症患者,手术时间为55~86 min,平均67 min; 手术出血量为6~15 mL,平均9 mL; 手术切口长度6~8 mm,平均7 mm; 住院时间3~7 d,平均5.2 d.血肿形成2例,术后髓核突出复发5例,出口神经根损伤2例,行走神经根及硬膜囊损伤1例,记号笔过敏1例,射频刀头电极片断裂3例,骨刀刀头部分断裂1例,术后骨块卡压神经2例,术中腰动脉损伤1例,11例出现类脊髓高压综合征,无麻药过敏、腹腔脏器损伤,无椎间隙及椎管内感染。所有患者均获得随访,时间为术后第3天,1个月及6个月近期随访。患者VAS评分从术前(7.14±2.23)分降至术后末次随访(1.25±0.21)分,差异有统计学意义(P<0.01); ODI从术前(41.3±4.81)分降至术后末次随访(9.8±6.12)分,差异有统计学意义(P<0.05)。按照脊柱MacNab评分标准,术后末次随访时优302例,良13例,差4例。结论:TESSYS技术治疗腰椎间盘突出症具有创伤小、出血少、术后恢复快、手术安全性高、住院时间短、对脊柱稳定性影响小、手术疗效肯定等优点; 同时可再次行椎间孔镜微创手术处理术后出血、复发、髓核残留、骨块残留等并发症,临床疗效肯定,是治疗腰椎间盘突出症很有效的微创手术方式,值得临床推广应用。

参考文献/References:

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更新日期/Last Update: 2019-10-10