【摘要】 目的:探讨生物蛋白胶及丹参注射液并用预防椎板切除术后硬膜和神经根周围粘连性下腰痛的发生率。方法:选择2002-01/2004-10昆明医学院第一附属医院骨科拟行下腰部椎板切除术后患者64例。治疗组35例在常规手术的基础上,以生物蛋白胶喷入硬膜囊及神经根周围后,逐层缝合切口。术后应用含有5g/L丹参(冻干粉)的葡萄糖注射液400mg静滴,1次/d,应用14d。同期29例行常规椎板切除术后不施以上述干预,作为对照组。两组分别经过8个月的随访。并采用日本骨科学会下腰痛疗效评分标准,于手术前、术后随访时进行评分,改善率以优(≥75%),良(50%～74%)为评估标准。结果:按意向处理分析,64例均进入结果分析。术后8个月随访评估时治疗组优26例,良6例,中3例,优良率91%(32/35),下腰痛发生率9%(3/35);对照组优15例,良5例,中6例,差3例,优良率69%(20/29),下腰痛发生率31%(9/29)。对照组下腰痛发生率明显高于治疗组(χ2=5.25,P<0.05)。结论:生物蛋白胶及丹参注射液联合应用能有效预防硬膜外粘连性下腰痛,减低其发生率。更多还原

【Abstract】 AIM:To investigate the effect of fibrin glue and danshen injection in the pre vention of lower back pain caused by adhesion of surrounding epidural scar and n erve root after laminectomy. METHODS:From January 2002 to October 2004,64 patients were treated with lumba r laminectomy in the Department of Orthopaedics,First Affiliated Hospital of Kun ming Medical University.Fibrin glue was spurted into dural sac and surrounding n erve root besides routine operation in 35 cases of treatment group.Then after op eration,5 g/L danshen(lyophilized powder) added into glucose injection 400 mg wa s dropped into vein once daily for total 14 days.Meanwhile,the other 29 cases in control group was treated nothing after routine laminectomy.Patients in the two groups were followed up for 8 months.The surgical outcome was evaluated with th e Japanese Orthopaedic Association(JOA) for low back pain score before operation ,and during the follow- up period after operation,using the criteria:equal to o r more than 75% as excellent improvement and 50% to 74% as good improvemen t. RESULTS:According to the intention management,all the 64 patients were includ ed in the result analysis.During the 8- month follow- up,26 cases were excelle nt,6 good,and 3 fair in the treatment group with the good and excellent rate of 91% (32/35) and the incidence of lower back pain of 9% (3/35);In the control g roup,5 cases were excellent,5 good,6 fair and 3 poor,with the good and excellent rate of 69% (20/29)and the incidence of lower back pain of 31% (9/29).Accordi ngly,the incidence of lower back pain was significantly higher in the control gr oup than in the treatment group(χ 2=5.25,P CONCLUSION:The combined injection using fibrin glue and danshen injection can effectively prevent lower back pain caused by epidural adhesion and reduce its incidence.更多还原