微通道技术在椎管内肿瘤切除术中的临床应用

Clinical application of microchannel technique in intraspinal tumor resection

中文关键词:  微通道技术  椎管内肿瘤  切除术

英文关键词:Microchannel technique  Intraspinal tumor  Resection

中文摘要:

  【摘要】 目的：探讨微通道技术在椎管内肿瘤切除术中的临床应用及效果。方法：回顾性分析2004年1月~2024年12月在定西市人民医院接受椎管内肿瘤切除术的20例患者的临床资料。根据手术方式不同分为观察组和对照组。观察组（n=9，男性3例，女性6例，年龄57.3±3.7岁）采用经皮微创通道椎旁入路切除术，术前神经功能McCormick分级Ⅰ级2例，Ⅱ级4例，Ⅲ级2例，Ⅳ级1例；对照组（n=11，男性5例，女性6例，年龄56.1±4.4岁）采用传统后路全椎板切开切除术，术前神经功能分级Ⅰ级3例，Ⅱ级5例，Ⅲ级3例。两组术前一般资料比较无显著统计学差异（P>0.05）。比较两组患者术中出血量、手术时间、住院时间、术后3d疼痛视觉模拟量表（visual analogue scale，VAS）评分、术后3个月神经功能恢复率及术后1年肿瘤复发率。结果：观察组和对照组手术时间无统计学差异（P＞0.05）。观察组术中出血量（53.1±8.1mL vs 100.5±10.1mL）、住院时间（7.0±1.7d vs 10.2±2.6d）及术后3d VAS评分（3.0±0.6分 vs 4.1±1.0分）均显著低于对照组（P<0.05）。两组间术后3个月神经功能恢复率[观察组（8/9，88.89%） vs 对照组（9/11，81.82%）]、术后1年肿瘤复发率[观察组（0/9，0.00%） vs 对照组（1/11，9.09%）]差异无统计学意义（P>0.05）。两组患者均未发生严重的手术并发症。结论：在椎管内肿瘤切除术中应用微通道技术，可取得与传统手术入路一致的短期临床疗效，同时可显著降低术中出血量，减轻患者术后即刻疼痛程度，缩短住院时间。

英文摘要:

  【Abstract】 Objectives: To explore the clinical application and efficacy of the microchannel technique in intraspinal tumor resection. Methods: A retrospective analysis was conducted on the clinical data of 20 patients who underwent intraspinal tumor resection at Dingxi People′s Hospital from January 2004 to December 2024. Patients were divided into two groups of observation group and control group according to surgical approach. The observation group(n=9, 3 males and 6 females, aged 57.3±3.7 years) underwent percutaneous microchannel approach resection surgery, and the neurological function gradings before operation were grade Ⅰ 2 cases, grade Ⅱ 4 cases, grade Ⅲ 2 cases, and grade Ⅳ 1 case; The control group(n=11, 5 males and 6 females, aged 56.4±4.4 years) received traditional posterior en bloc laminectomy resection, and the neurological function gradings before operation were grade Ⅰ 3 cases, grade Ⅱ 5 cases, and grade Ⅲ 3 cases. There was no statistical difference in the preoperative general information between the two groups(P>0.05). Intraoperative blood loss, operative time, length of hospital stay, postoperative 3d visual analogue scale(VAS) score, neurological recovery rate at 3 months postoperatively, and tumor recurrence rate at 1 year postoperatively were compared between the two groups. Results: There was no significant difference in operative time between the two groups(P>0.05). The observation group was significantly less in intraoperative blood loss(53.1±8.1mL vs 100.5±10.1mL), shorter in length of hospital stay(7.0±1.7d vs 10.2±2.6d), lower in VAS score at postoperative 3d(3.0±0.6 vs 4.1±1.0), all with statistical differences(P<0.05). There were no significant differences in the neurological recovery rate[Observation group(8/9, 88.89%) vs Control group(9/11, 81.82%)] at 3 months postoperatively or the 1-year tumor recurrence rate[Observation group(0/9, 0.00%) vs Control group(1/11, 9.09%)](P>0.05). No serious surgical complications occurred in either group. Conclusions: The application of microchannel technique in intraspinal tumor resection can achieve the same short-term clinical efficacy as the traditional surgical approach. However, the application of microchannel technique can significantly reduce intraoperative blood loss, alleviate the immediate postoperative pain of patients, and shorten the hospital stay.