经皮内镜下椎板减压术治疗老年腰椎管狭窄症患者的效果
冉林川 张可方 张新安
郑州大学附属郑州中心医院骨科
摘要：目的：探究经皮内镜下椎板减压术治疗老年腰椎管狭窄症患者的效果。方法：选取125例老年腰椎管狭窄症患者作为研究对象，根据随机数字表法分为两组。对照组62例给予开放式半椎板减压术治疗，观察组63例给予经皮内镜下椎板减压术治疗，分析两组患者围手术期指标、腰椎稳定性和椎管微炎症情况。结果：观察组手术时间长于对照组，术中出血量少于对照组，术后卧床时间及住院时间均短于对照组（P＜0.05）;术后，两组椎间隙前缘高度、节段活动度比较无统计学差异（P＞ 0.05）;观察组椎间隙后缘高于对照组（P＜0.05）;术后，观察组MCP-1、IL-1α、TNF-α水平均低于对照组（P＜0.05）。结论：经皮内镜下椎板减压术治疗老年腰椎管狭窄症可增强腰椎稳定性，提高治疗效果。
关键词：经皮内镜下椎板减压术;老年患者;腰椎管狭窄症;腰椎稳定性;椎管微炎症;
Effect of percutaneous endoscopic laminectomy on elderly patients with lumbar spinal stenosis
RAN Linchuan,ZHANG Kefang,ZHANG Xinan.(Dept. of Orthopedics,Zhengzhou CentralHospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)
AbstractObjective: To investigate the effect of percutaneous endoscopic laminectomy on elderly patientswith lumbar spinal stenosis. Methods: 125 elderly patients with lumbar spinal stenosis were selected as theresearch objects, and were randomized into two groups, with 62 cases in control group and 63 cases in theobservation group. The control group were treated with open hemilaminectomy, while the observation groupwere treated with percutaneous endoscopic laminectomy. Perioperative indicators, lumbar stability andmicroinflammation of the spinal canal of patients were compared between the two groups. Results: Theoperation time, the amount of intraoperative blood loss, postoperative bed time and postoperative hospitalstays for patients in the observation group were lower than that of the control group (P< 0. 05); aftersurgery, there were no significant differences in the anterior height of the intervertebral space and theactivity of the segment between the two groups(P>0.05); the posterior height of the intervertebral space inobservation group was higher than that of control group(P<0.05); and the levels of McP-1, IL-1α andTNF-α in observation group were lower than those in control group (P< 0. 05). Conclusion: For senilelumbar spinal stenosis, the treatment with percutaneous endoscopic laminectomy can enhance the stabilityof lumbar spine and improve the therapeutic effect.
Keywords: percutaneous endoscopic laminectomy; elderly patients; lumbar spinal stenosis; lumbarstability; microinflammation of the spinal canal
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