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[目的]观察扩张通道管系统(X-tube)辅助微创经椎间孔入路腰椎椎体间融合术(minimally invasive surgery transforaminal lumbar interbody fusion,MIS-TLIF)与传统开放后路腰椎椎体间融合术(posterior lumbar interbody fusion,PLIF)治疗单节段退行性腰椎疾病的相关临床疗效,并比较其护理措施。[方法]回顾性分析2013年12月~2014年12月本院骨科行手术治疗的单节段退行性腰椎病变患者,其中行MIS-TLIF手术的患者48例、行PLIF手术的患者39例,统计术前心理评估指标、术中出血量、术后伤口引流量、术后1d直腿抬高度数、术后卧床时间、术后平均住院天数、腰背痛视觉模拟评分(visual analogue scale,VAS)以及术后康复锻炼的完成情况,并对两组结果进行比较。[结果]手术前HAMA评分、HAMD评分、SAS评分和SDS评分,PLIF组均高于MIS-TLIF组(P<0.05);MIS-TLIF组术中出血量、术后伤口引流量、术后卧床时间、术后平均住院天数均比PLIF组明显减少(P<0.05),术后1 d直腿抬高度数则明显增加(P<0.05),术后第3、5 d及3个月,MIS-TLIF组腰背痛VAS评分明显低于PLIF组(P<0.05),术后1 d和3 d,MIS-TLIF组康复锻炼完成率明显高于PLIF组。[结论]MIS-TLIF手术治疗单节段退行性腰椎疾病手术切口小,术前患者的心理负担较小,术后伤口疼痛轻,可提早进行康复锻炼,缩短了平均住院天数,减少并发症的发生,一定程度减轻了护理工作量,在把握好适应证的情况下,值得在有条件开展此类手术的医院进行推广。
[Objective] To observe the effect of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) combined with traditional open posterior lumbar interbody fusion Objective To evaluate the clinical efficacy of posterior lumbar interbody fusion (PLIF) in the treatment of single-grade degenerative lumbar disease and to compare its nursing measures. [Methods] A retrospective analysis of patients with unilateral segmental degenerative lumbar disease underwent orthopedic surgery from December 2013 to December 2014 in our hospital. 48 patients underwent MIS-TLIF operation, 39 patients underwent PLIF operation, Statistics preoperative psychological evaluation index, intraoperative blood loss, postoperative wound drainage, postoperative straight leg raising degree 1d, postoperative bed rest time, postoperative average length of stay, low back pain visual analogue scale (VAS ) And the completion of postoperative rehabilitation exercise, and the results of two groups were compared. [Results] The preoperative HAMA score, HAMD score, SAS score and SDS score in PLIF group were significantly higher than those in MIS-TLIF group (P <0.05). The intraoperative blood loss, postoperative wound drainage, postoperative bed rest (P <0.05). The straight leg raising degree on the first postoperative day was significantly increased (P <0.05). On the 3rd, 5th, and 3rd month after operation, the MIS The VAS score of low back pain in TLIF group was significantly lower than that in PLIF group (P <0.05). The completion rate of rehabilitation training in MIS-TLIF group was significantly higher than that of PLIF group on the 1st and 3rd postoperative day. [Conclusion] The MIS-TLIF surgical treatment of single segmental degenerative lumbar disease surgical incision is small, preoperative patients with less psychological burden, postoperative wound pain is light, early rehabilitation exercise, shorten the average length of stay, reduce complications Occurred, to a certain extent, reduce the workload of nursing, in the case of a good indication, it is worth carrying out the promotion of such surgery in hospitals.