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[采用微创通道治疗椎管内肿瘤的手术策略]

[Surgical strategy of intraspinal tumors using minimal invasive channels].

作者信息

Xie R, Shou J J, Chen G, Che X Y, Dong Y H, Li J Q, Che X M

机构信息

Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2020 Feb 4;100(4):265-269. doi: 10.3760/cma.j.issn.0376-2491.2020.04.005.

Abstract

To compare and analyze the effect of minimally invasive surgery and traditional open surgery in patients with spinal canal tumors, including intraspinal and extraspinal communication tumors. From 2017 to 2019, 31 patients (minimally invasive channel group) were included in the neurosurgery department of Huashan Hospital Affiliated to Fudan University, and 38 patients (open operation group) were selected as the control group. From the aspects of intraoperative condition, operative effect, postoperative muscle injury, postoperative complications, postoperative spinal stability, the minimally invasive access group and the open operation group were compared and analyzed. The bleeding volume (70.2 ml±4.9 ml), operation time (164.7 min±16.0 min) and hospitalization days (9.5±2.5) in the minimally invasive access group were significantly lower than those in the open operation group (0.001). The creatine kinase CK (363.9 U/L±51.6 U/L) in the minimally invasive group was significantly lower than that in the open group (514.2 U/L±68.3 U/L) (0.001). According to Panjabi standard, the effect of spinal cord stability in minimally invasive group was significantly lower than that in open operation group (0.001), and the symptom improvement rate in minimally invasive group was significantly higher than that in open hand group (0.05). Compared with the open surgery, the amount of bleeding, the length of incision, the time of operation and the days of hospitalization were significantly shorter, the degree of muscle damage was also significantly reduced, the incidence of complications was lower, the impact of spinal stability was smaller, and the overall advantage was obvious.

摘要

比较和分析微创手术与传统开放手术对椎管肿瘤患者(包括椎管内和椎管外沟通性肿瘤)的治疗效果。2017年至2019年,复旦大学附属华山医院神经外科纳入31例患者(微创通道组),选取38例患者作为对照组(开放手术组)。从术中情况、手术效果、术后肌肉损伤、术后并发症、术后脊柱稳定性等方面,对微创入路组和开放手术组进行比较分析。微创入路组的出血量(70.2 ml±4.9 ml)、手术时间(164.7 min±16.0 min)和住院天数(9.5±2.5)均显著低于开放手术组(P<0.001)。微创组的肌酸激酶CK(363.9 U/L±51.6 U/L)显著低于开放组(514.2 U/L±68.3 U/L)(P<0.001)。根据Panjabi标准,微创组的脊髓稳定性效果显著低于开放手术组(P<0.001),微创组的症状改善率显著高于开放手术组(P<0.05)。与开放手术相比,出血量、切口长度、手术时间和住院天数明显缩短,肌肉损伤程度也显著减轻,并发症发生率较低,对脊柱稳定性的影响较小,总体优势明显。

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