顯微鏡下硬膜下穿刺沖洗治療腰段脊髓損傷的療效分析

馮文杰　鄧海棠　孔志強　鄒凱　張震乾　蘇曉恩

【摘要】 目的：探討腰段脊髓損傷采取顯微鏡下硬膜下穿刺沖洗治療的效果。方法：選取2016年7月-2018年5月本院接收的60例腰段脊髓損傷患者，將患者按照隨機數字表法分為對照組（n=30）與觀察組（n=30），兩組均行椎板減壓椎弓根螺釘內固定手術，觀察組在此基礎上采用顯微鏡行硬膜下穿刺沖洗損傷部位的脊髓神經，對兩組的療效及相關指標進行觀察和比較。結果：治療后6個月，觀察組ASIA分級情況明顯優于對照組，差異有統計學意義（P<0.05）。治療后1、6個月，觀察組患者的FIM及Barthel評分均顯著高于對照組，差異均有統計學意義（P<0.05）。治療后1、6個月，觀察組患者的運動評分明顯高于對照組，差異均有統計學意義（P<0.05）。結論：對于腰段脊髓損傷患者，采用顯微鏡下硬膜下穿刺沖洗治療，能有效改善患者的脊柱神經功能，改善患者的生活自理能力和運動功能，安全性較高，值得推廣。

【關鍵詞】 腰段脊髓損傷; 硬膜下穿刺沖洗; 顯微鏡

【Abstract】 Objective：To discuss the efficacy of microscopic subdural puncture and flushing in lumbar spinal cord injury.Method：60 lumbar spinal cord injury patients treated from July 2016 to May 2018 in our hospital were selected，patients were divided into control group（n=30）and observation group（n=30）according to the random number table method.Both groups were treated with laminar decompression and pedicle screw internal fixation，and the observation group was treated with subdural puncture to flush the injured spinal nerves，the curative effect and relative indexes of the two groups were observed and compared.Result：6 months after treatment，the ASIA grading in the observation group was significantly better than that in the control group，with statistically significant difference（P<0.05）.1 and 6 months after treatment，the FIM and Barthel scores of patients in the observation group were significantly higher than those in the control group，with statistically significant differences（P<0.05）.1 and 6 months after treatment，the exercise scores of patients in the observation group were significantly higher than those in the control group，the differences were statistically significant（P<0.05）.Conclusion：The microscopic subdural puncture and flushing can efficiently improve the spinal nerve function，self-help ability，motor function and clinical safety，it is worthy of promotion.

【Key words】 Lumbar spinal cord injury; Subdural puncture and flushing; Microscope

First-authors address：Zhaoqing First Peoples Hospital，Zhaoqing 526000，China

doi：10.3969/j.issn.1674-4985.2019.08.007

【摘要】 目的：探討腰段脊髓損傷采取顯微鏡下硬膜下穿刺沖洗治療的效果。方法：選取2016年7月-2018年5月本院接收的60例腰段脊髓損傷患者，將患者按照隨機數字表法分為對照組（n=30）與觀察組（n=30），兩組均行椎板減壓椎弓根螺釘內固定手術，觀察組在此基礎上采用顯微鏡行硬膜下穿刺沖洗損傷部位的脊髓神經，對兩組的療效及相關指標進行觀察和比較。結果：治療后6個月，觀察組ASIA分級情況明顯優于對照組，差異有統計學意義（P<0.05）。治療后1、6個月，觀察組患者的FIM及Barthel評分均顯著高于對照組，差異均有統計學意義（P<0.05）。治療后1、6個月，觀察組患者的運動評分明顯高于對照組，差異均有統計學意義（P<0.05）。結論：對于腰段脊髓損傷患者，采用顯微鏡下硬膜下穿刺沖洗治療，能有效改善患者的脊柱神經功能，改善患者的生活自理能力和運動功能，安全性較高，值得推廣。