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目的 :探讨椎板成形术在椎管内肿瘤术中的临床疗效。方法 :回顾性分析本院2008年1月~2014年1月收治的102例具有完整临床资料的椎管内肿瘤患者。根据其手术治疗方式将患者分为治疗组与对照组。其中治疗组采取椎板成形术,共72例;对照组行椎板切除术,共30例。比较两组患者手术时间、术中出血量、肿瘤全切率、术后切口脑脊液漏发生率、术后1个月脊髓神经功能恢复程度,根据随访记录,比较患者术后2年脊髓神经功能恢复程度、椎管腔最窄处的截面积、脊柱不稳率、脊柱成角畸形发生率。结果 :术中治疗组手术出血量显著低于对照组;对照组术后切口脑脊液漏发生率(16.7%)显著高于治疗组(2.8%)。随访2年后治疗组椎管腔最窄处的截面积明显高于对照组。治疗组脊柱不稳率及脊柱成角畸形发生率均显著低于对照组。术后2年治疗组脊髓神经功能有效恢复率(91.7%)显著高于对照组(73.3%),差异具有统计学意义;其余均无统计学差异。结论 :采用椎板成形术开放椎管,出血量更少,术后脑脊液漏发生率低,疗效更佳,值得临床推广应用。
Objective: To investigate the clinical effect of laminoplasty in spinal canal tumor. Methods: A retrospective analysis of our hospital from January 2008 to January 2014 admitted to 102 patients with complete clinical data of patients with spinal canal tumor. Patients were divided into treatment group and control group according to the surgical treatment. The treatment group took laminectomy, a total of 72 cases; control group, laminectomy, a total of 30 cases. The operation time, intraoperative blood loss, total tumor resection rate, the incidence of postoperative cerebrospinal fluid leakage and the degree of recovery of spinal nerve function 1 month after surgery were compared. According to the follow-up records, the neurological function of the spinal cord was recovered 2 years after the operation Degree, the narrowest cross-sectional area of spinal canal, spinal instability, the incidence of spinal deformity. Results: The intraoperative blood loss was significantly lower in the treatment group than in the control group. The incidence of postoperative cerebrospinal fluid leakage (16.7%) in the control group was significantly higher than that in the treatment group (2.8%). After 2 years of follow-up, the cross-sectional area of the narrowest spinal canal in the treatment group was significantly higher than that in the control group. The incidence of spinal instability and spinal deformity in the treatment group were significantly lower than those in the control group. The effective recovery rate of spinal cord nerve function (91.7%) in the 2-year postoperative group was significantly higher than that in the control group (73.3%), the difference was statistically significant; the rest had no statistical difference. Conclusion: Open laminoplasty with laminoplasty has less bleeding, less postoperative cerebrospinal fluid leakage and better curative effect, which is worthy of clinical application.