不同手术入路对显微切除中胸段椎管内肿瘤手术的影响

目的比较半椎板入路显微手术与全椎板入路显微手术分别用于中胸段椎管内肿瘤的切除手术时临床疗效的差异。方法 2010年1月~2016年6月期间,将我院进行胸段椎管内肿瘤手术的患者分为两组,其中观察组32例患者(采用半椎板入路显微切除术治疗)和对照组28例患者(采用全椎板入路显微切除进行手术)。比较两组患者围手术期指标以及疗效、脊椎稳定性和并发症发生情况的差异。结果两组患者均成功进行了手术,半椎板显微手术比较全椎板入路显示良好的临床效果,两组患者在手术时间比较(t=8.473,P0.001)、术中出血量(t=17.612,P0.001)、住院时间(t=16.655,P0.001)及下床时间(t=54.138,P0.001)存在显著差异,两组患者术后随访脊柱稳定性的差异有统计学意义(χ~2=6.184,P=0.013);并发症发生情况的差异无统计学意义(χ~2=0.312,P=0.576)。结论半椎板显微手术与全椎板入路相比,手术过程中的临床疗效更为优越。

Treatment strategy of hemilaminectomy or laminectomy microsurgery for intraspinal tumor of thoracic spine

Objective To analyze and compare the clinical effect of intraspinal tumor of thoracic spine between hemilaminectomy approach and complete laminectomy approach. Methods The clinical database was reviewed for patients with intraspinal tumor of thoracic spine who underwent surgical procedure by hemilaminectomy approach or total laminectomy between January 2010 and June 2016. Of 60 cases received surgery，32 underwent hemilaminectomy approach（observation group）and 28 complete laminectomy（control group）. The perioperative indicators，curative effect，the spinal stability and complications were compare between two groups. Results After surgery，the preoperative symptoms improved in all patients. Compared with complete laminectomy approach ，hemilaminectomy microsurgery showed better clinical effect. There were significant differences between the two groups in the operation time （t=8.473 ，P<0.001），the amount of intraoperative bleeding （t=17.612 ，P<0.001），the time of hospitalization（t=16.655，P<0.001），the time to go out of bed（t=54.138，P<0.001），spinal stability （χ2=6.184，P=0.013）. There was no statistically significant difference in the incidence of complications between two groups. Conclusion The clinical efficacy of hemilaminectomy approach for treatment of intraspinal tumor of thoracic spine is better than that of the laminectomy .