单切口显微内窥镜下椎间盘切除术与传统开放椎间盘切除术治疗双节段腰椎间盘突出症的对比研究  

Microendoscopic discectomy by single-incision versus open discectomy for double-segmental lumbar disc herniation

作　　者：刘军[1] 项良碧[1] 王琪[1] 陈语[1] 朴美慧[1] 杨会峰[1] 季锋[1] 罗杰 马骏雄[1] 

机构地区：[1]沈阳军区总医院骨科全军重症战创伤救治中心,110016 [2]四川省军区内江军分区医疗科

出　　处：《中华临床医师杂志（电子版）》2013年第8期59-61,共3页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的比较单切口显微内窥镜下椎间盘切除术(MED)与传统开放椎间盘切除术(OD)治疗双节段腰椎间盘突出症的临床疗效。方法 2009年1月至2011年1月在我科接受椎间盘切除手术的双节段腰椎间盘突出症患者,共25例,入院时随机分为MED组(n=12)和OD组(n=13),分析比较两组患者的手术时间、麻醉时间、住院时间、住院费用、术中出血量、摘除椎间盘重量、手术切口长度、Oswestry评分的改善情况以及临床效果满意率。结果 MED组的手术时间、麻醉时间明显高于OD组(P<0.05),MED组的术中出血量、切口长度、术后下床时间、住院时间、住院费用等明显小于OD组(P<0.05)。两组术中摘除髓核组织重量无明显差别(P>0.05)。和术前相比,术后MED组和OD组的Oswestry评分具有明显改善,但术前和术后两组间均无明显差别(P>0.05)。两组间临床效果满意率无明显差异(P>0.05)。结论对于双节段腰椎间盘突出症患者,OD和单切口MED均是有效的治疗方法。但单切口MED术中出血量少、切口长度小、术后下床时间早、住院时间短、住院费用低,更加符合微创理念。Objective To compare the outcomes of microendoscopic discectomy （MED）by single-incision versus open discectomy（OD） for double-segmental lumbar disc herniation. Methods From January 2009 to January 2011,25 patients with a double-segmental lumbar disc herniation were randomized to undergo MED（ n = 12）by single-incision or OD（n = 13）. The 2 groups were compared with respect to surgical time,anaesthesia time,duration of hospital stay,intra-operative blood loss,weight of disc material removed,length of operative incision, improvement in Oswestry score and satisfaction rate of clinical outcome. Results Surgical and anaesthesia times were significantly longer（P 〈 0. 05 ）, but blood loss, length of operative incision, time of postoperative bed rest, hospital stay and cost were significantly reduced in MED group than OD group（P 〈 0. 05）. The weight of disc material removed was similar between the two groups （P 〉 0. 05 ）. The improvement in Oswestry score in both groups were significant after the operation, but Oswestry score were similar in both groups （ P 〉 0. Q5 ）. Satisfaction rate of clinical outcome were similar in both groups （P 〉 0. 05 ）. Conclusions Both methods are equally effective in treating double-segmental lumbar disc herniation. However, MED by single-incision entailed less intra-operative blood loss, shorter length of operative incision, less time of postoperative bed rest and hospital stay, less hospital cost, which consists with the demand of minimal invasion.

关 键 词：椎间盘移位 椎间盘切除术 单切口 

分 类 号：R687.3[医药卫生—骨科学]