经皮椎间孔镜治疗单节段腰椎间盘突出症患者的效果观察

杨嘉; 曹宏强

doi:10.7619/jcmp.201911023

经皮椎间孔镜治疗单节段腰椎间盘突出症患者的效果观察

杨嘉¹,
曹宏强^2,

1.
陕西省宝鸡市中医医院脊柱骨病一科, 陕西宝鸡, 721001
2.
陕西省延长县人民医院骨科, 陕西延安, 717199

详细信息

通讯作者:
曹宏强

中图分类号: R681.5
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出版历程
- 收稿日期: 2019-04-12
- 录用日期: 2019-05-16
- 网络出版日期: 2021-02-22
- 发布日期: 2019-06-14

Effect observation of percutaneous transforaminal endoscopic discectomy on treatment of patients with single-segment lumbar disc herniation

YANG Jia¹,
CAO Hongqiang^2,

1.
The First Department of Spinal Osteopathy, Baoji Hospital of Traditional Chinese Medicine, Baoji, Shaanxi, 721001
2.
Department of Orthopedics, Yanchang County People′s Hospital, Yan'an, Shaanxi, 717199

摘要

摘要:
目的探讨经皮椎间孔镜治疗单节段腰椎间盘突出症患者的临床效果。
方法选取100例单节段腰椎间盘突出症患者, 根据手术方案分为2组各50例。对照组行后路椎间盘镜下腰椎间盘切除术，观察组行经皮椎间孔镜手术。比较2组的手术效果，手术前后患者的疼痛、腰椎功能活动情况，以及并发症发生率。
结果观察组患者术中出血量、手术切口长度、术后卧床时间、术后住院时间显著优于对照组(P < 0.05)。观察组并发症发生率4.00%, 显著低于对照组18.00% (P < 0.05)。2组患者的术前视觉模拟评分法(VAS)、手术前和术后1个月的功能障碍指数(ODI)评分比较无显著差异(P>0.05); 术后1个月，观察组患者的VSA评分显著低于对照组(P < 0.05)。
结论采用经皮椎间孔镜治疗腰椎间盘突出症效果显著。
- 单节段腰椎间盘突出症 /
- 经皮椎间孔镜椎间盘切除术 /
- 腰椎功能 /
- 疼痛 /
- 功能障碍指数
Abstract:
Objective To investigate the clinical effect of percutaneous transforaminal endoscopic discectomy on treatment of patients with single-segment lumbar disc herniation.
Methods Totally 100 patients with single-segment lumbar disc herniation were divided into two groups according to different surgical procedures, with 50 cases in each group. The control group underwent posterior lumbar discectomy under discoscopy, while the observation group underwent percutaneous transforaminal discectomy. The surgical effects, pain, lumbar vertebral function and complications before and after operation were compared between the two groups.
Results The bleeding volume, incision length, bed rest time and hospitalization time of the patients in the observation group were significantly better than those in the control group (P < 0.05). The incidence rate of complications in the observation group was 4.00%, which was significantly lower than 18.00% in the control group (P < 0.05). There were no significant differences in pre-operative visual analogue score (VAS), dysfunction index (ODI) scores before and 1 month after operation between the two groups (P>0.05). One month after operation, the VSA score of the observation group was significantly lower than that of the control group (P < 0.05).
Conclusion Percutaneous transforaminal endoscopic discectomy is effective in treatment of patients with single-segment lumbar disc herniation.
- single-segment lumbar disc herniation /
- percutaneous transforaminal endoscopic discectomy /
- lumbar function /
- pain /
- dysfunction index

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表 1 2组患者手术治疗情况对比(x±s)

指标	观察组(n=50)	对照组(n=50)
手术切口长度/cm	0.86±0.29^*	2.27±0.64
术中出血量/mL	39.84±12.72^*	115.27±21.93
术后卧床时间/h	10.64±2.16^*	46.39±12.68
术后住院时间/d	8.17±1.39^*	10.37±1.45
与对照组比较, *P < 0.05。

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表 2 2组并发症发生情况对比[n(%)]

组别	n	脊膜破裂	感染	神经根损伤	合计
观察组	50	0	1(2.00)	1(2.00)	2(4.00)^*
对照组	50	2(4.00)	3(6.00)	4(8.00)	9(18.00)
与对照组比较, *P < 0.05。

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表 3 2组患者手治疗前后ODI指数和VAS评分对比(x±s) 分

组别	n	ODI评分		VAS评分
组别	n	术前	术后1个月	术前	术后1个月
观察组	50	51.28±10.61	37.34±10.17^*	8.01±1.27	3.08±1.03^*#
对照组	50	51.86±10.37	38.75±10.82^*	8.13±1.34	4.21±1.15^*
VAS: 视觉模拟评分法; ODI: 功能障碍指数。与术前比较, *P < 0.05; 与对照组比较, #P < 0.05。

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经皮椎间孔镜治疗单节段腰椎间盘突出症患者的效果观察

通讯作者: 曹宏强

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Effect observation of percutaneous transforaminal endoscopic discectomy on treatment of patients with single-segment lumbar disc herniation

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通讯作者:
曹宏强