椎间盘镜手术系统治疗中老年腰椎间盘突出症的临床效果观察  

Clinical effects of microendoscopic discectomy in the treatment of lumbar disc herniation in the elderly

作　　者：谭斌 刘雄文 胡辉林 刘刚 黎永生 秦忠军 杨春鹏 

机构地区：[1]广西脑科医院骨科,广西柳州545005

出　　处：《海南医学》2015年第5期654-657,共4页Hainan Medical Journal

基　　金：广西科学研究与技术开发项目(编号:桂科攻0592007-3B)

摘　　要：目的探讨采用椎间盘镜手术系统(MED)对中老年腰椎间盘突出症患者的治疗效果。方法回顾性分析我院骨科2010年2月至2013年4月收治的100例腰椎间盘突出症患者的临床诊治资料。根据手术方式分为经皮内镜下腰椎间盘突出切除术44例(对照组)、采用MED治疗56例(MED组),比较两组患者的术中情况,术前及术后12个月、术后24个月的视觉模拟疼痛评分(VAS)、Oswestry功能障碍指数及Nakia疗效评价情况。结果对照组的手术时间明显短于MED组(P<0.05),而MED组患者的术中出血量、卧床时间、住院时间明显短于对照组(P<0.05)。术前两组患者的VAS、ODI评分差异均无统计学意义(P>0.05),两组患者术后第12个月、24个月的VAS、ODI评分均较术前明显好转(P<0.05),但术后两组患者的ODI评分差异无统计学意义(P>0.05),术后MDE组的VAS评分在第12个月、24个月均显著优于对照组(P<0.01)。术后两组患者的Nakia疗效分布及总有效率比较差异无统计学意义(P>0.05)。结论椎间盘镜手术系统治疗中老年腰椎间盘突出症患者较经皮内镜下腰椎间盘突切除术具有减少患者术中出血量、住院时间、卧床时间、术后疼痛的优势,同时治疗效果良好。Objective To discuss the therapeutic effect of microendoscopic discectomy （MED） in the treat-ment of lumbar disc herniation （LDH） in the elderly. Methods A retrospective analysis was performed in 100 pa-tients with lumbar disc herniation in our hospital from February 2010 to April 2013. The patients were divided into two groups according to surgical procedures： the control group （treated with percutaneous endoscopic resection, 44 cases）, the MED group （treated with MED, 56 cases）. The two groups were compared in intraoperative situation, post-operative visual analog pain score （VAS） and Oswestry disability index and Nakia curative effect evaluation before surgery, 12 and 24 months after surgery. Results The operative time was significantly shorter in the control group than MED group （P〈0.05）, while blood loss, bed time, length of hospital stay was significantly shorter in MED group than the control group （P〈0.05）. VAS, ODI scores showed no statistically significant difference between the two groups before surgery （P〉0.05）, and they were significantly improved 12, 24 months after surgery （P〈0.05）. In the MED group, ODI scores after surgery showed no statistically significant difference with the control group （P〉0.05）, but VAS scores 12, 24 months after surgery were significantly higher than the control group （P〈0.01）. There was no statistically significant difference between the two groups in the distribution of Nakia effect and the total effective rate after surgery （P〉0.05）. Conclusion For the treatment of lumbar disc herniation in the elderly, microendoscopic discectomy, compared with percutaneous endoscopic resection, can reduce the blood loss, length of hospital stay, bed time, postoperative pain, with a good therapeutic effect.

关 键 词：椎间盘镜手术系统 中老年 腰椎间盘突出症 经皮内镜下腰椎间盘突切除术 

分 类 号：R681.53[医药卫生—骨科学]