等离子消融术和前路椎间盘摘除术在颈椎间盘突出症治疗中的效价比分析  

THE COMPARISON OF COST-EFFECTIVENESS OF PERCUTANEOUS COBLATION NUCLEOPLASTY WITH THE ANTERIOR CERVICAL DISCECTOMY IN THE TREATMENT OF CERVICAL DISC HERNIATION

作　　者：朱谦[1] 韦宏宇[2] 毛鹏[1] 王海宁[1] 刘波涛[1] 苗羽[1] 闫龙涛[1] 樊碧发[1] 

机构地区：[1]卫计委中日友好医院疼痛科,北京100029 [2]卫计委中日友好医院脊柱外科,北京100029

出　　处：《中国疼痛医学杂志》2015年第6期437-440,448,共5页Chinese Journal of Pain Medicine

摘　　要：目的:回顾性研究低温等离子消融术与颈前路椎间盘摘除融合术治疗颈椎间盘突出症的效价比。方法:选择我院行颈前路椎间盘摘除融合术或低温等离子消融术的患者25例,按手术方式分为低温等离子消融组(D组,n=13例)和颈前路椎间盘摘除融合组(S组,n=12例)。分析术前椎间盘突出程度、手术时间、术后平均住院日、住院费用及术后1天、术后1个月、术后3个月的NRS(Numerical rating scale,NRS)和JOA(Japanese orthopaedic association,JOA)评分变化。结果:两组患者术后1天、术后1个月、术后3个月的NRS评分较术前均出现明显下降(P<0.01),JOA评分明显改善(P<0.05),但两组之间没有明显差异(P>0.05)。D组的手术时间、术后平均住院日、住院费用明显低于S组(P<0.05)。结论:低温等离子消融术和颈前路椎间盘摘除融合术均可有效治疗颈椎间盘突出症,与颈前路椎间盘摘除融合术相比,低温等离子消融术效价比更高,创伤更小,恢复更快。Objective： Review the cost-effectiveness of the treatment of cervical disc herniation by percutaneous coblation nucleoplasty and anterior cervical discectomy and fusion. Methods： Twenty-five patients in our hospital who underwent percutaneous coblation nucleoplasty or anterior cervical discectomy and fusion were allocated to two groups according to the therapy： percutaneous coblation nucleoplasty group （group D, n = 13） and anterior cervical discectomy and fusion group （group S, n = 12）. The preoperative degree of disc herniation, operative time, postoperative hospitalization days, cost of hospitalization and the changes of NRS （Numerical Rating Scale） scores and JOA （Japanese Orthopaedic Association） scores at the point of before operation and 1 day, 1 month, 3 months after operation were observed and analyzed. Results： There is no significant difference between the two groups about the cervical disc herniation degree, NRS scores and JOA scores before operation （P 〉 0.05）. The NRS scores were significantly decreased （P 〈 0.01）, JOA scores were improved significantly （P 〈 0.05） at 1st day, 1 month and 3 months after surgery in both groups than the preoperative scores. The operation time, the average hospitalization days, cost of hospitalization in group D was significantly lower than in group S （P 〈 0.05）. Conclusion： Both percutaneous coblation nucleoplasty and anterior cervical discectomy and fusion can treat cervical disc herniation effectively, but percutaneous coblation nucleoplasty can provide better cost-effectiveness andproduce less injury and faster recovery than anterior cervical discectomy and fusion.

关 键 词：颈椎间盘突出症 低温等离子消融术 颈前路椎间盘摘除融合术 效价比 

分 类 号：R687.3[医药卫生—骨科学]