[1]韩 松,李红卫,俞鹏飞,等.经肌间隙入路TLIF术联合消髓化核汤治疗腰椎退行性疾病的效果研究[J].医学信息,2020,33(12):84-87.[doi:10.3969/j.issn.1006-1959.2020.12.024]
　HAN Song,LI Hong-wei,YU Peng-fei,et al.Study on the Effect of TLIF Combined with Xiaosuihuahe Decoction in Treating Degenerative Diseases of Lumbar Spine[J].Medical Information,2020,33(12):84-87.[doi:10.3969/j.issn.1006-1959.2020.12.024]
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经肌间隙入路TLIF术联合消髓化核汤治疗腰椎退行性疾病的效果研究()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年12期
页码:
84-87
栏目:
论著
出版日期:
2020-06-15

文章信息/Info

Title:
Study on the Effect of TLIF Combined with Xiaosuihuahe Decoction in Treating Degenerative Diseases of Lumbar Spine
文章编号:
1006-1959（2020）12-0084-04
作者:
韩 松; 李红卫; 俞鹏飞; 等
（南京中医药大学附属苏州市中医医院骨伤科脊柱外科，江苏 苏州 215009）
Author(s):
HAN Song; LI Hong-wei; YU Peng-fei; et al
(Department of Orthopedic Spine，Suzhou Traditional Chinese Medicine Hospital Affiliated to Nanjing Universityof Traditional Chinese Medicine,Suzhou 215009,Jiangsu,China)
关键词:
肌间隙入路; TLIF; 消髓化核汤
Keywords:
Muscle clearance approach; TLIF; Xiaosuihuahe Decoction
分类号:
R966
DOI:
10.3969/j.issn.1006-1959.2020.12.024
文献标志码:
A
摘要:
目的 分析经椎旁肌间隙入路减压融合术（TLIF）联合消髓化核汤治疗腰椎退行性疾病效果及预后。方法 选取我院2017年8月~2019年8月收治的需行单节段腰椎TLIF术的腰椎退行性疾病患者61例，采用随机数字表法分为肌间隙组、传统组、联合组。肌间隙组20例患者行经肌间隙入路TLIF术，传统组22例行传统腰椎后路经椎间孔入路减压植骨融合内固定术（TLIF）治疗，联合组19例患者接受经肌间隙入路TLIF联合消髓化核汤治疗。比较各组手术时间、术中出血量、术后引流量、住院天数、术前1天、术后1天、术后1、3、6个月VAS评分及ODI指数评分。结果 三组术前VAS评分比较，差异无统计学意义（P＞0.05），术后1天及术后1个月肌间隙组VAS评分低于传统组（P＜0.05）；术后3、6个月联合组VAS评分低于肌间隙组和传统组（P＜0.05）；三组术前ODI评分比较，差异无统计学意义（P＞0.05）；术后3、6个月肌间隙组ODI评分低于传统组（P＜0.05）；联合组术后3、6个月随访ODI评分低于肌间隙组和传统组（P＜0.05）；肌间隙组和联合组术中出血量、术后引流量少于传统组，差异有统计学意义（P＜0.05）；三组手术时长以及住院天数比较，差异无统计学意义（P＞0.05）。结论 肌间隙组和联合组相较传统组而言，可减少腰椎退行性疾病手术出血量、术后引流量，减轻手术患者早期腰背痛，而联合组在联合使用消髓化核汤后较肌间隙组可以提高术后ODI指数，巩固远期疗效，促进功能恢复。
Abstract:
Objective To analyze the effect and prognosis of decompressive fusion (TLIF) combined with Xiaosuihuahe Decoction in the treatment of lumbar degenerative diseases.Methods 61 patients with degenerative diseases of the lumbar spine who needed single-segment lumbar TLIF to be treated in our hospital from August 2017 to August 2019 were selected and divided into the intermuscular space group, the traditional group and the combined group by the random number table method. 20 patients in the intermuscular space group underwent TLIF through the intermuscular space approach, 22 patients in the traditional group underwent conventional posterior lumbar intervertebral foramen approach decompression and bone graft fusion and internal fixation (TLIF), and 19 patients in the combined group received transmuscular interstitial approach TLIF combined with Xiaosuihuahe Decoction. The operation time, intraoperative blood loss, postoperative drainage volume, days of hospitalization, 1 day before surgery, 1 day after surgery, 1, 3, and 6 months after surgery were compared between the VAS scores and ODI index scores.Results There was no statistically significant difference in the VAS scores between the three groups before operation (P>0.05). The VAS scores of the muscle gap group at 1 day and 1 month after operation were lower than those in the traditional group (P<0.05);At 3 and 6 months after surgery, the VAS score of the combined group was lower than that of the muscle gap group and the traditional group (P<0.05); there was no statistically significant difference in the preoperative ODI scores of the three groups (P>0.05);The ODI score of the muscle gap group was lower than that of the traditional group at 3 and 6 months after operation (P<0.05); the ODI score of the combined group was lower than that of the muscle gap group and the traditional group at 3 and 6 months after operation (P<0.05);The intramuscular space group and the combined group had less intraoperative blood loss and postoperative drainage volume than the traditional group,the difference was statistically significant (P<0.05); there was no statistically significant difference between the three groups in the length of operation and the length of hospital stay (P>0.05).Conclusion Compared with the traditional group, the intermuscular space group and the combined group can reduce the amount of surgical bleeding and postoperative drainage of lumbar degenerative diseases, and reduce the early low back pain of the surgical patients. The intermuscular space group can improve the postoperative ODI index, consolidate the long-term efficacy, and promote functional recovery.

参考文献/References:

[1]类风湿关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,4(14):256-270.[2]Husberg M,Bernfort L,Hallert E.Costs and disease activity in early rheumatoid arthritis in 1996-2000 and 2006-2011, improved outcome and shift in distribution of costs: a two-year follow-up[J].Scand J Rheumatol,2018,47(5):378-383. [3]薛燕,王翠萍.皮温测量的影响因素分析及皮温测量规范测量的制定[J].临床医学实践,2004(3):216-218.[4]李晓会,张忠恒,魏臻.人体表面温度分布与内部病灶特征的研究[J].生命科学仪器,2007,5(12):32-34.[5]李洪霞,曾光宇.用红外热像仪分析人体的温度分布和病灶[J].红外,2010,31(1):44-48.[6]Honsawek S,Deepaisarnsakul B,Tanavalee A.Relationship of serum IL-6，C-reactive protein，erythrocyte sedimentationrate，and knee skin temperature after total knee arthroplasty:a prospective study[J].Int Orthop,2011,35(1):31-35.[7]叶奕,庞清江,张建光.初次全膝关节置换术后膝关节皮温测定意义[J].临床骨科杂志,2012,15(5):514-516.[8]Greenwald M,Ball J,Guerrettaz K,et al.Using Dermal Temperature to Identify Rheumatoid Arthritis Patients With Radiologic Progressive Disease in Less Than One Minute[J].Arthritis Care Res (Hoboken),2016,68(8):1201-1205.[9]Smolen JS,Breedveldn FC,Schiff MH.A simplified disease activity index for rheumatoid arthritis for use in clinical practice[J].Rheumatology(Oxford),2003,42(2):244-257.

更新日期/Last Update: 1900-01-01