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颈前路“杂交式”与颈后路治疗多节段脊髓型颈椎病的临床比较
  • ISSN号:1673-6273
  • 期刊名称:《现代生物医学进展》
  • 时间:0
  • 分类:R681.55[医药卫生—骨科学;医药卫生—临床医学;医药卫生—外科学]
  • 作者机构:[1]石河子大学医学院临床医学系,新疆石河子832002, [2]石河子大学新疆地方与民族高发病教育部重点实验室,新疆石河子832002, [3]吐鲁番市人民医院骨科,新疆吐鲁番838000, [4]新疆医科大学第一附属医院骨科中心,新疆乌鲁木齐830000, [5]石河子大学医学院基础医学系,新疆石河子832002, [6]石河子大学医学院第一附属医院骨科中心,新疆石河子832002
  • 相关基金:国家自然科学基金项目(81660271);石河子大学3152青年骨干教师项目(cZ0260)
中文摘要:

目的:比较颈前路“杂交式”减压融合与颈后路全椎板减压侧块内固定术治疗多节段脊髓型颈椎病的临床特点。方法:选择36例行“杂交式”颈前路治疗及33例行颈后路全椎板减压侧块内固定术治疗的多节段脊髓型颈椎病患者,观察两组患者手术前后一般资料、出血量、手术时间、颈椎生理曲度、JOA评分及并发症的发生情况。结果:两组患者术前的一般资料包括年龄(颈前路组:56.23±7.64岁,颈后路组:55.76±8.18岁)、性别(颈前路组:22男/14女,颈后路组:20男/13女)、颈椎生理曲度D值(颈前路组:7.41±3.14,颈后路组:8.19±2.74)、JOA评分(颈前路组:9.08±1.09分,颈后路组:8.82±1.26分)、病程(颈前路组:17.24±7.36月.颈后路组:15.75±5.78月)和受累节段(颈前路组:3.11±0.26个,颈后路组:3.24+0.39个)比较差异均无统计学意义(P〉0.05)。与颈后路相比,颈前路的术中出血量(颈前路组:221.79±178.02mL,颈后路组:483.07±434.25mL)更少,差异有统计学意义(P〈O.05),手术时间旧{前路组:196.54±51.88min,颈后路组:175.12±54.93min)更长,但差异无统计学意义(P〉0.05)。随着时间的延长,颈前路组患者颈椎生理曲度和JOA评分逐渐增大,而颈后路组患者椎生理曲度减少,JOA评分逐渐增大,差异有统计学意义(P〈0.05)。颈前路组出现植骨未融合、声音嘶哑和脑脊漏液,颈后路组发生轴性疼痛和c5神经根麻痹,但两组患者并发症的发生率比较差异无统计学意义(颈前路组:13.89%,颈后路组:12.12%)(P〉0.05)。结论:颈前路“杂交式”减压融合与颈后路全椎板减压侧块内固定术在治疗多节段脊髓型颈椎病上各有优点,临床根据患者的情况而采取合适的治疗方式。

英文摘要:

Objective: To compare the therapeutic characteristics of anterior hybrid decompression and posterior cervical posterior laminectomy in the treatment of multilevel cervical spondylotic myelopathy. Methods: Thirty six cases of multilevel cervical spondylotic myelopathy patients treated by anterior hybrid decompression and thirty three cases of multilevel cervical spondylotic myelopathy patients treated by posterior cervical posterior laminectomy were involved. The general information, bleeding amount, operative time, cervical curvature D value, JOA score and incidence of postoperative complications of the two groups before and after surgery were compared. Results: There was no significant difference in the general information among the two groups(P〉0.05), including age (anterior group: 56.23±7.64 years old, posterior group: 55.76±8.18 years old), sex (anterior group: 22 males/14 females, posterior group: 20 males/13 females), cervical curvature D value (anterior group: 7.41 ±3.14, posterior group: 8.19±2.74), JOA score (anterior group:9.08±1.09 scores, posterior group: 8.82±1.26 scores), disease course (anterior group: 17.24±7.36 months, posterior group: 15.75±5.78 months) and affected segment (anterior group: 3.11± 0.26 segments, posterior group: 3.24±0.39 segments). The the amount of bleeding in the anterior group (anterior approach: 221.79±178.02 ml, posterior group: 483.07±434.25 ml) was lower than that of the posterior group(P〈0.05). The operative time (anterior group: 196.54+ 51.88 mins, posterior group: 175.12±54.93 mins) was longer, but there was no significant difference (P〉0.05). The cervical curvature D value and JOA score of posterior group were increased with the extension of surgery time. However, the cervical curvature D value of posterior group was decreased, but JOA score was increased. The incidence of bone unfinished, hoarseness and cerebrospinal fluid leakage were found in the anterior group, a

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期刊信息
  • 《现代生物医学进展》
  • 中国科技核心期刊
  • 主管单位:黑龙江省卫生厅
  • 主办单位:黑龙江省红十字医院 黑黑龙江省红十字医院 黑龙江省森林工总医院
  • 主编:申宝忠
  • 地址:哈尔滨市南岗区花园街184号403
  • 邮编:150001
  • 邮箱:biomed_54@126.com
  • 电话:0451-82583800 53658268
  • 国际标准刊号:ISSN:1673-6273
  • 国内统一刊号:ISSN:23-1544/R
  • 邮发代号:14-12
  • 获奖情况:
  • 国内外数据库收录:
  • 被引量:33230