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[1]王棟,高文碩,洪奕胡,等.單側(cè)雙通道內(nèi)鏡技術(shù)治療游離型腰椎間盤突出癥[J].中醫(yī)正骨,2022,34(04):64-69.
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單側(cè)雙通道內(nèi)鏡技術(shù)治療游離型腰椎間盤突出癥()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期數(shù):
2022年04期
頁碼:
64-69
欄目:
臨床報(bào)道
出版日期:
2022-04-20

文章信息/Info

作者:
王棟高文碩洪奕胡張良平朱承躍程偉張偉潘浩
(浙江中醫(yī)藥大學(xué)附屬杭州市中醫(yī)院,浙江 杭州 310007)
關(guān)鍵詞:
椎間盤移位 腰椎 內(nèi)窺鏡
摘要:
目的:探討單側(cè)雙通道內(nèi)鏡技術(shù)治療游離型腰椎間盤突出癥的臨床療效和安全性。方法:對(duì)接受單側(cè)雙通道內(nèi)鏡技術(shù)手術(shù)治療的28例游離型腰椎間盤突出癥患者的病例資料進(jìn)行回顧性分析。男16例,女12例; 年齡29~81歲,中位數(shù)52歲。病變節(jié)段L3~43例、L4~514例、L5S111例; 髓核向頭側(cè)游離8例、向尾側(cè)游離20例。均有腰痛,伴或不伴下肢疼痛麻木或間歇性跛行,Oswestry功能障礙指數(shù)(Oswestry disability index,ODI)>30%。記錄手術(shù)前后患者腰部、腿部疼痛視覺模擬量表(visual analogue scale,VAS)評(píng)分和ODI,采用改良的MacNab療效評(píng)定標(biāo)準(zhǔn)評(píng)價(jià)療效,觀察并發(fā)癥發(fā)生情況。結(jié)果:本組28例患者,均順利完成手術(shù)。手術(shù)時(shí)間70~135 min,中位數(shù)87 min; 術(shù)后住院時(shí)間2~9 d,中位數(shù)3 d。均獲隨訪,隨訪時(shí)間6~12個(gè)月,中位數(shù)7個(gè)月。切口均甲級(jí)愈合。患者腰痛VAS評(píng)分,術(shù)前(5.07±0.71)分、術(shù)后即刻(4.25±0.75)分、術(shù)后1個(gè)月(2.32±0.67)分、術(shù)后6個(gè)月(1.21±0.57)分、末次隨訪時(shí)(0.79±0.63)分; 腿痛VAS評(píng)分,術(shù)前(6.56±0.79)分、術(shù)后即刻(3.43±0.63)分、術(shù)后1個(gè)月(2.11±0.63)分、術(shù)后6個(gè)月(1.50±0.76)分、末次隨訪時(shí)(1.04±0.64)分; ODI,術(shù)前(56.39±8.66)%、術(shù)后1個(gè)月(38.54±6.48)%、術(shù)后6個(gè)月(25.54±5.41)%、末次隨訪時(shí)(16.79±3.74)%。末次隨訪時(shí),本組患者療效優(yōu)20例、良6例、可1例、差1例。差的1例為減壓不充分、髓核殘留,癥狀改善不明顯,二期在椎間孔鏡下行髓核摘除術(shù)。均無感染、硬脊膜撕裂、硬脊膜外血腫、神經(jīng)根損傷等并發(fā)癥發(fā)生。結(jié)論:采用單側(cè)雙通道內(nèi)鏡技術(shù)治療游離型腰椎間盤突出癥,有利于緩解患者腰腿疼痛、改善腰椎功能,且并發(fā)癥少。

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備注/Memo

備注/Memo:
基金項(xiàng)目:浙江省醫(yī)藥衛(wèi)生科技計(jì)劃項(xiàng)目(2020KY225,2022KY999)通訊作者:潘浩 E-mail:[email protected]
更新日期/Last Update: 1900-01-01