传统开放减压与单侧开窗潜行减压手术治疗双侧椎管狭窄的临床疗效对比

目的 比较不同减压术式治疗双侧椎管狭窄的临床疗效及安全性.方法 将本院骨科2015年1月至2016年3月收治的82例双侧椎管狭窄患者随机分为两组,对照组(40例)采用传统开放减压手术方法治疗,观察组(42例)采用单侧开窗潜行减压治疗.比较两组患者的手术指标及临床疗效的差异.结果 观察组患者手术时间、术中出血量、术后引流量、术后3d肌酸激酶水平分别为(101.4±36.2)min、(167.3±64.8) ml、(96.5±77.4) ml、(188.12±15.26) U/L,对照组分别为(136.1±46.5) min、(385.3±166.7)ml、(312.9±137.9)ml、(251.23±17.86)U/L,观察组手术指标明显优于对照组(P＜0.05);观察组患者术后下床时间和平均住院时间分别为(2.2±0.4)d、(5.5±3.8)d,明显短于对照组的(4.3±3.3)d、(7.7±5.5)d,差异有统计学意义(P＜0.05);两组患者术后3个月的VAS评分和ODI评分较治疗前均有所改善(P＜0.05),且观察组明显优于对照组(P＜0.05).结论 单侧开窗潜行减压治疗双侧椎管狭窄症疗效显著,手术创伤小、术后康复快,具有较高的临床推广价值.

The comparison of the clinical efficacy of traditional open surgical decompression and unilateral fenestration decompression in the treatment of bilateral spinal stenosis

Objective To compare the clinical efficacy and safety of different decompression in the treatment of bilateral spinal stenosis.Methods 82 cases of bilateral spinal stenosis in our hospital from January 2015 to March 2016 were randomly divided into two groups,control group (40 cases) was treated with traditional open surgical decompression,while observation group (42 cases) was treated with unilateral fenestration decompression.Compared the differences of operation indexes and clinical efficacy between two groups.Results The operation time,blood loss during operation,drainage volume after operation,creatine kinase level 3 d after operation of observation group were (101.4±36.2)min,(167.3±4.8)ml,(96.5±77.4)ml,(188.12±15.26)U/L,and those of control group were (136.1±46.5)min,(385.3±166.7)ml,(312.9±137.9)ml,(251.23±17.86)U/L,the operation indexes of observation group were significantly better than those of control group (P＜0.05).The postoperative bed time and average hospital stay of observation group were (2.2±0.4)d,(5.5±3.8)d,obviously shorter than (4.3±3.3)d,(7.7±5.5)d of control group,with statistically significant differences (P＜0.05).VAS score and ODI score of two groups significantly improved 3 months after operation (P＜0.05),and those of observation group were better than those of control group (P＜0.05).Conclusion Unilateral fenestration decompression has significant effect in the treatment of bilateral spinal stenosis,with less trauma and faster recovery,which has high clinical value.