脊柱内镜手术在椎管狭窄症中的疗效及对结构参数的影响研究

杜超群 郝德强 刘忠诚 陈丽萍 王文

【摘要】 目的：探究脊柱內镜手术在椎管狭窄症中的疗效及对结构参数的影响。方法：选取2017年8月-2020年5月本院120例椎管狭窄症患者，将其随机分为对照组和观察组，每组60例。对照组采用传统开放式手术治疗，观察组采用脊柱内镜手术治疗。比较两组治疗优良率、治疗前及治疗后不同时间的ODI评分结果、结构参数（椎间隙前缘高度、椎间隙后缘高度及椎管面积）及血清疼痛介质表达水平（SP、PGE2及β-EP）。结果：观察组治疗优良率高于对照组，差异有统计学意义（P<0.05）。治疗前，两组的ODI评分结果、血清疼痛介质表达水平及结构参数比较，差异均无统计学意义（P>0.05）。治疗后1、3个月，观察组的ODI评分结果及结构参数均优于对照组，治疗后3、7 d观察组的血清疼痛介质表达水平均低于对照组，差异均有统计学意义（P<0.05）。结论：脊柱内镜手术在椎管狭窄症中的疗效较好，且对结构参数影响更为积极，应用价值相对更高。

【关键词】 脊柱内镜手术 椎管狭窄症 结构参数

Study on the Effect of Spinal Endoscopic Surgery in Patients with Spinal Stenosis and Influence for Structural Parameters/DU Chaoqun， HAO Deqiang， LIU Zhongcheng， CHEN Liping， WANG Wen. //Medical Innovation of China， 2021， 18（16）： 0-024

[Abstract] Objective： To investigate the effect of spinal endoscopic surgery in patients with spinal stenosis and influence for structural parameters. Method： A total of 120 patients with spinal stenosis in our hospital from August 2017 to May 2020 were selected. They were randomly divided into control group and observation group， 60 cases in each group. The control group was treated with traditional open surgery， and the observation group was treated with spinal endoscopic surgery. The excellent and good rate of treatment， ODI scores ， structural parameters （anterior edge height， posterior edge height and spinal canal area） and serum pain mediators expression level （SP， PGE2 and β-EP） before and different times after treatment were compared between the two groups. Result： The excellent and good rate of treatment of observation group was higher than that of control group， the difference was statistically significant （P<0.05）. Before treatment， there were no significant differences in ODI score， the expression level of serum pain mediators and structural parameters between two groups （P>0.05）. At 1 and 3 months after treatment， the ODI scores and structural parameters of observation group were superior than those of control group， and the the expression level of serum pain mediators of observation group were lower than those of control group at 3 and 7 days after treatment， the differences were statistically significant （P<0.05）. Conclusion： Spinal endoscopic surgery has a good effect in spinal stenosis， and has a more positive influence on structural parameters， so its application value is relatively higher in patients with spinal stenosis.

[Key words] Spinal endoscopic surgery Spinal stenosis Structural parameters

First-author’s address： Heng’an Hospital of Traditional Chinese Medicine， Beijing Zhongjingyuan Academy of Medical Sciences， Beijing 100124， China

doi：10.3969/j.issn.1674-4985.2021.16.005

椎管狭窄症患者中保守治疗无效且加重者多主张采用手术的方式进行治疗。随着临床对手术质量及微创需求的提升，脊柱内镜手术在本类患者中的应用率不断提升，与之相关的各方面是研究重点[1-2]。除相关的功能改善等指标外，治疗后的局部结构参数也是其疗效评估的重要方面，因此对本类患者进行脊柱内镜手术治疗的过程中，上述方面的检测意义均较高。本研究就脊柱内镜手术在椎管狭窄症应用中的效果及对结构参数的影响进行探究，现报道如下。……