摘要
目的:研究髓核摘除术后纤维环缝合的临床疗效,并从纤维环缝合术前后血清及引流液中炎症因子浓度的比较探讨纤维环缝合意义。方法:选择2015年10月-2017年10月武汉六七二中西医结合医院脊柱外科收治的40例腰椎间盘突出患者,均行髓核摘除术,其中20例纤维环缝合者为观察组,未纤维环缝合者为对照组,比较2组术前,术后1周,3个月,1年后VAS评分,腰椎ODI评分,并记录包括椎间盘再突出在内的并发症发生情况;检测2组手术前、手术后第1天,1个月后血液标本以及术后第1,2,3天引流液中磷脂酶A2及肿瘤坏死因子α的浓度。结果:随访1周、3个月时观察组腰背痛VAS评分、ODI评分均优于对照组(P<0.05)、随访1年时,2组腰背痛VAS评分、ODI评分无明显统计学差异.组间无统计学差异(P>0.05),观察组引流液中不同时间点的2种炎症因子水平均低于对照组(P<0.05),血清中不同时间点的2种炎症因子水平无统计学差异(P>0.05)。结论:髓核摘除手术后纤维环缝合可以减少炎症因子的渗出和释放,有利于缓解症状、腰椎功能恢复,对减少术后复发和再手术率具有明显作用,是一种可行的方案。
Objective:To investigate the clinical effects of lumbar intervertebral discs annulus suture,and discuss the clinical significance of annulus suture according to the inflammation factor concentrations in blood and drainage fluid.Methods:A total of 40 patients with lumbar disc herniation in the department of spinal surgery of Wuhan 672 Chinese and Western Medicine hospital between October 2015 and October 2017,who underwent discectomy ,including 20 cases of annulus suture (experimental group),and 20 cases of fiber ring was not closed(control group),Oswestry disability index and visual analog scale scores were recorded before and at 7 days,3 months,and 12 months after operation.The concentrations of TNF-a and PLA2 in the blood samples were determined before and at 1 day,1 month after surgery,which concentrations were determined in drainage fluid at 1,2 and 3 days after surgery in the experimental and control groups.Results:At a week and a mouth after surgery,the Oswestry disability index and visual analog scale scores were better in the repair group (P < 0.05 ),but there was no difference after a year.The concentrations of TNF-a and PLA2 in drainage fluid were significantly lower in the experimental group than those in the control group at 3 days ( P < 0.05).but there was no difference in the blood samples.Conclusion:These results suggested that annulus suture can reduce the concentrations of TNF-a and PLA2 after discectomy in fluid drainage,and the postoperative recurrence and operation rate,which is safe and reliable in clinic.
作者
陈旺
胡胜利
朱凌
谢维
严浩
高雪伟
杨波
陈祝江
CHEN Wang;HU Sheng-li;ZHU Ling(Department of spinal surgery,Wuhan 672 integrated Chinese and western medicine hospital,Wuhan 430000)
出处
《中国伤残医学》
2019年第5期3-6,共4页
Chinese Journal of Trauma and Disability Medicine
作者简介
陈旺,硕士,住院医师,研究方向:脊柱(中西医结合治疗脊柱疾病),单位:武汉六七二中西医结合骨科医院脊柱外科,地址:湖北省武汉市珞喻路279号,邮编:430079,电话:18986029211.
