后路椎间盘镜髓核摘除术联合椎旁神经阻滞治疗腰椎间盘突出症的疗效  

Microendoscopic Discectomy Combined with Paravertebral Nerve Block for Lumbar Disc Herniation

作　　者：李卫星[1] 康健[1] 程亮[1] 梁芳[1] 刘波[1] 邹亿城[1] 陈海滨[1] 

机构地区：[1]东莞市太平人民医院疼痛科,广东东莞523900

出　　处：《实用临床医学（江西）》2015年第6期27-29,共3页Practical Clinical Medicine

基　　金：广东省科技厅科研计划项目(粤科规划字[2013]137号)

摘　　要：目的探讨后路椎间盘镜髓核摘除术(MED)联合椎旁神经阻滞(PVB)治疗腰椎间盘突出症的临床疗效。方法将220例腰椎间盘突出症患者按随机数字表法分为2组:治疗组112例采用MED联合PVB治疗,对照组108例采用开放椎板开窗术(OD)联合PVB治疗。比较2组治疗前后VAS评分变化及手术情况(手术时间、手术切口、出血量)、术后情况(术后3d最高体温、住院时间);采用Nakai评分评价2组的临床疗效。结果与治疗前相比,2组治疗后的VAS评分均显著下降(P<0.05或P<0.01);与对照组比较,治疗组治疗后VAS评分、手术时间、手术切口、出血量、术后3d最高体温、住院时间均显著减少(P<0.05或P<0.01)。治疗组临床疗效优良率显著高于对照组(97.32%比87.96%,P<0.05)。结论 MED联合PVB治疗腰椎间盘突出症具有切口小、组织创伤少、术中出血少、术后恢复快等优点。ABSTRACT:Objective To investigate the clinical efficacy of microendoscopic discectomy (MED) combined with paravertebral nerve block (PVB)in the treatment of lumbar disc herniation.Meth-ods A total of 220 patients with lumbar disc herniation were randomly assigned to receive PVB in combination with either MED (treatment group,n=112)or open discectomy (control group, n= 108).Changes in VAS scores before and after treatment,operation time,surgical incision, blood loss,highest body temperature on postoperative day 3,and length of hospital stay were compared between the two groups.Clinical efficacy was evaluated by Nakai scoring.Results VAS scores significantly decreased after treatment in both groups (P <0.05 or P <0.01).Compared with control group,VAS scores,operation time,surgical incision,blood loss,highest body temper-ature on postoperative day 3 and length of hospital stay significantly decreased in treatment group (P <0.05 or P <0.01).In addition,the excellent and good rate of clinical outcome in treatment group was significantly higher than that in control group (97.32% vs 87.96%,P <0.05).Conclu-sion The combined treatment with MED and PVB is associated with smaller incision,less tissue trauma and intraoperative bleeding and faster recovery in patients with lumbar disc herniation.

关 键 词：腰椎间盘突出症 后路椎间盘镜髓核摘除术 椎旁神经阻滞 开放椎板开窗术 

分 类 号：R682.13[医药卫生—骨科学]