论文部分内容阅读
目的 探讨I期减压手术对颈椎管狭窄合并腰椎管狭窄症患者的治疗效果及手术方法 .方法回顾性分析2012年1月至2016年1月,我院手术治疗的72例多节段椎管狭窄患者的临床资料,根据手术方法分为A组32例(行I期减压手术颈腰椎联合减压)、B组40例(采用传统分期手术),对比两组患者的手术时间、术中出血量、下床时间、住院时间、日本骨科协会(Japanese orthopaedic association,JOA)评分、疼痛视觉模拟评分(visual analog pain score,VAS).结果 A组患者的手术出血量、手术时间均大于B组,差异有统计学意义(P0.05),A组患者的总住院时间低于B组,差异有统计学意义(P<0.05);术后1个月、6个月、末次随访,A组患者的JOA评价项目(上肢运动功能、下肢运动功能、感觉功能、膀胱功能)评分均高于同期B组,差异有统计学意义(P<0.05);术后2、8、12、24 h,A组患者的VAS评分均高于同时间点B组,差异有统计学意义(P0.05).结论 I期减压手术治疗颈椎管狭窄合并腰椎管狭窄症患者相对于分期手术,手术时间较长、出血量较多,但是术后患者脊髓神经功能恢复更好,同时患者的住院时间更短.“,”Objective To explore the therapeutic effects and surgical methods of I stage decompression in the treatment of cervical spinal stenosis complicated with lumbar spinal stenosis. Methods The clinical data of 72 patients with multi-segmental spinal stenosis, treated surgically in our hospital from January 2012 to January 2016, were retrospectively analyzed. According to the surgical methods, all patients were divided into 2 groups: Group A, n = 32, stage I decompression of the cervical and lumbar spine; Group B, n = 40, traditional staged surgery. The operation time, intraoperative blood loss, bedtime, hospitalization time, Japanese Orthopaedic Association ( JOA ), visual analog scale ( VAS ) were compared between the 2 groups. Results The amount of blood loss and operation time in Group A were greater and longer than those in Group B with statistical significance ( P 0.05 ). The total length of stay in Group A was shorter than that in Group B with statistical significance ( P < 0.05 ). At 1 month, 6 months, and the latest follow-up, the mean JOA scores ( upper extremity motor function, lower extremity motor function, sensory function, bladder function ) in Group A were higher than those in Group B with statistical significance ( P < 0.05 ). At 2, 8, 12 and 24 hours after operation, the VAS scores in Group A were higher than those in Group B with statistical significance ( P 0.05 ). Conclusions I stage decompression has longer operation time and more bleeding than traditional staged surgery in the treatment of cervical spinal stenosis combined with lumbar spinal stenosis. However, postoperative spinal nerve functions are better, and hospital stay is shorter.