| Objective:To investigate general characteristics and clinical manifestations of patients who underwent lumbar disc herniation(LDH) surgery, and to explore related factors influencing the improvement rate of surgical treatment.MethodsAll patients with LDH who underwent spine surgery at Hospital Affiliated to Chifeng College from June, 2012 to June, 2016 were collected. Data, including gender, age, occupation, past medical history, family history, hospitalization days and cost were collected and analyzed.Results(1)the general situation: the average age of patients in this study was 45.91±11.87 years old,86.6% patients were in the age of 60 years old,and it is more common in males by a ratio of 1.80:1(149/83),animal husbandry workers accounted for 72.84% of total patients. 128 patients have a history of disease,accounting for 55.2% of the total patients. Among them,there were 50 cases with family history, accounting for 21.6% of the total cases. 113(48.7%) patients had been smoking,129(55.6%) patients had been drinking.(2)The basic situation of patients:out of the 232 patients,the main clinical symptoms of lower limb pain were 211(90.9%),120 cases(56.9%) had left lower extremity pain,115 cases(49.6%) had lower limb weakness, 65 cases(28%) had numbness,low back pain in 195(84.1%), With other symptoms,there were 36(15.5%) patients with limited travel restriction,and 0.4%(1 patient) with fecal incontinence. out of the 232 patients,229 cases had lumbar spine mobility,157 cases of patients with lumbar sacral local tenderness,142 cases of patients with lower extremity sensory abnormalities,115 cases of patients with lower limb muscle tension abnormalities.196 cases were positive for Straight leg raising test,102 cases were positive for Achilles tendon reflex,79 cases were positive for knee jerk reflex.(3)General situation of operation:The average length of hospital stay was 15 days, the average cost of hospitalization was 17695.20 yuan, and the average amount of bleeding was 200 ml.discectomy bone graft internal fixation for a total of 132(56.9%),simple discectomy in 100(43.1%). for simple discectomy:The average hospitalization days were 12.5±9,the average cost was 13670.17±9043.2yuan,the average operation time was 90±43.75 min, the average amount of bleeding in operation was 121.5±114.50ml;for discectomy bone graft internal fixation:The average length of hospital stay was 16±4.75 d, the average cost was 40202.37±31878.84 yuan,the average operation time was 105±38.75 min,the average blood loss was 200±194ml.(4)Analysis of curative effect after operation: patient combined with other diseases was a influenced factors of improvement rate of surgical treatment(X2 =6.397,P=0.011). But after Multivariate logistic analysis, there were no related factors that influenced postoperative effect.(5)Analysis of surgical methods: There were no statistical significant between simple discectomy and discectomy bone graft internal fixation in duration of hospitalization, hospitalization costs, operation time, and intraoperative bleeding volume(P<0.05).Conclusion(1)Patients with LDH surgery is more concentrated in the age of 60 years old,and it is more common in males.(2)Waist pain, lower limb pain(pain in the left leg is more common)are important symptoms of LDH, and often accompanied with numbness, weakness, limited mobility and other symptoms.(3)When admitted to the hospital, the ratio of patients with positive leg elevation test and /or abnormal lumbar motion is relatively higher than the other clinical signs.(4)The removal of nucleus pulposus was superior to that of bone graft and internal fixation... |
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