| 牛朋彦,熊尚文,冯婷,韩志红,王志强.微创经椎间孔减压腰椎融合内固定治疗老年腰椎退行性病变患者的近期效果[J].中国临床保健杂志,2023,26(2):197-201. |
| 微创经椎间孔减压腰椎融合内固定治疗老年腰椎退行性病变患者的近期效果 |
| Short-term follow-up study of minimally invasive transforaminal lumbar interbody fusion and internal fixation in the treatment of elderly patients with lumbar degenerative disease |
| 投稿时间：2022-08-04 |
| DOI：10.3969/J.issn.1672-6790.2023.02.013 |
| 中文关键词: 椎间盘退行性变 腰椎 最小侵入性外科手术 老年人 |
| 英文关键词: Intervertebral disc degeneration Lumbar vertebrae Minimally invasive surgical procedures Aged 〖FL |
| 基金项目:河北省邯郸市科学技术研究与发展计划项目(21422083068) |
| 作者 | 单位 | E-mail | | 牛朋彦 | 邯郸市第一医院,脊柱与骨肿瘤一科,邯郸 056002 | 18931091176@163.com | | 熊尚文 | 邯郸市第一医院,脊柱与骨肿瘤一科,邯郸 056002 | | | 冯婷 | 邯郸市第一医院,家庭病床科,邯郸 056002 | | | 韩志红 | 邯郸市第一医院,脊柱与骨肿瘤一科,邯郸 056002 | | | 王志强 | 邯郸市第一医院,脊柱与骨肿瘤一科,邯郸 056002 | |
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| 中文摘要: |
| 目的 探讨微创经椎间孔减压腰椎融合内固定术(MIS-TLIF)治疗老年腰椎退行性病变的临床效果。方法 选取邯郸市第一医院2019年7月至2021年7月收治的老年腰椎退行性病变患者92例,按照随机数字表法分为对照组和观察组,各46例。对照组患者给予传统后路开放经椎间孔椎间融合内固定术(TLIF)进行治疗,观察组患者给予MIS-TLIF进行治疗,2组均于术后随访6个月。比较2组手术指标,术前及术后1 d凝血功能、疼痛介质,术前及术后1个月疼痛及骨骼功能各项评分指标,术后6个月并发症发生情况。结果 观察组手术时间、术后下床活动时间、住院时间短于对照组,术中出血量均低于对照组；与术前比,2组术后1 d血浆凝血酶原时间(PT)延长,但观察组短于对照组(P＜0.05)；血浆纤维蛋白原(FIB)、血浆D-二聚体(D-dimer)、血清β-内啡肽(β-EP)、前列腺素E2(PGE2)、降钙素基因相关肽(CGRP)水平均升高,但观察组低于对照组；与术前比,2组术后1个月日本骨科协会评估治疗(JOA)评分均升高,且观察组高于对照组,视觉模拟量表(VAS)及Oswestry功能障碍指数(ODI)评分均降低,观察组低于对照组(P＜0.05)；术后6个月内,观察组并发症总发生率低于对照组,差异均有统计学意义(P<0.05)。结论 老年腰椎退行性病变患者采用MIS-TLIF进行治疗,可抑制疼痛介质分泌,减轻疼痛程度,促进机体功能的恢复,减少并发症,且对于凝血功能的影响较小。 |
| 英文摘要: |
| Objective To investigate the clinical effect of minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF) in the treatment of elderly patients with lumbar degenerative disease.Methods A total of 92 elderly patients with lumbar degenerative disease who were treated in our hospital from July 2019 to July 2021 were selected and divided into the control group and the observation group according to the random number table method,with 46 cases in each group.The patients in the control group were treated with transforaminal lumbar interbody fusion(TLIF),and the patients in the observation group were treated with MIS-TLIF.Both groups were followed up for 6 months after operation.The surgical indicators,coagulation function,pain mediators before and the 1th day after surgery,the scores of pain and skeletal function before and 1 month after surgery,and 6 months postoperative complications were compared between the two groups.Results The operation time,postoperative ambulation time and hospital stay in the observation group were shorter than those in the control group,and the intraoperative blood loss was lower than that in the control group;Compared with before operation,the plasma prothrombin time (PT) in the two groups at the 1th after operation prolonged,but the observation group was shorter than the control group (P＜0.05);plasma fibrinogen (FIB),plasma D-dimer (D-dimer),serum beta-endorphin(β-EP),prostaglandin E2 (PGE2) and calcitonin gene-related peptide (CGRP) all increased,but the observation group was lower than the control group (P＜0.05);Compared with preoperative,the Japanese Orthopaedic Association Assessment and Treatment (JOA) scores in the two groups increased at the 1th month after surgery,and the observation group was higher than the control group.The visual analog scale (VAS) and Oswestry disability index (ODI) scores decreased,and the observation group was lower than the control group (P＜0.05);Within 6 months after operation,the total incidence of complications in the observation group was lower than that in the control group,and the differences were statistically significant (all P<0.05).Conclusions MIS-TLIF can inhibit the secretion of pain mediators,reduce the pain degree,promote the recovery of body function,reduce complications with little effect on coagulation function in elderly patients with lumbar degenerative disease. |
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