经皮椎间盘镜与椎间孔镜技术治疗腰椎间盘突出症临床对比分析  

Comparison of Efficacy between Microendoscopic Discectomy and Percutaneous Endoscopic Lumbar Discectomy for Treatment of Lumbar Disc Herniation

作　　者：赵新文[1] 韩康[2] 姬振伟[1] 李钊[1] 王志学 吴鹏[1] 丁勇[2] 

机构地区：[1]第四军医大学唐都医院全军骨科中心,陕西西安710038 [2]济南军区总医院脊髓修复科,山东济南250000

出　　处：《现代生物医学进展》2016年第23期4454-4457,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81371926);济南军区总医院院长基金项目(2015ZX01)

摘　　要：目的:比较椎间盘镜髓核摘除术(microendoscopic discectomy,MED)与椎间孔镜髓核摘除术(percutaneous endoscopic lumbar discectomy,PELD)治疗腰椎间盘突出症的优缺点、安全性及临床疗效。方法:分析和回顾2012.06-2015.06第四军医大学唐都医院骨科收治的共计118例腰椎间盘突出症患者。经严格的进行纳入和排除标准筛选,其中椎间盘镜组共纳入患者46例,椎间孔镜组患者共纳入患者72例。对所有患者均进行了6个月以上的术后随访,记录和分析两组患者在手术时间、卧床时间、出血量、切口长度、疼痛、并发症等指标。并通过Macnab腰椎功能评分等对两组患者的功能恢复进行比较。结果:在术后,两组患者在疼痛评分及功能恢复方面均有明显的提高,且两组之间并无显著统计学差异(P>0.05)。而椎间孔镜组在手术时间、卧床时间,总花费等指标中要优于椎间盘组(P<0.05)。但在住院时间,出血量,切口长度及并发症等方面两组无明显的显著性差异(P>0.05)。结论:两种手术方式作为脊柱微创手术,能够有效地治疗腰椎间盘突出症,安全程度较高,各有其优劣性,在临床中应根据不同的患者的实际情况进行个性化的选择。Objective： To compare the clinical effect and safety of patients with lumbar disc herniation treated with microendoscopic discectomy（MD） and percutaneous endoscopic lumbar discectomy（PELD）. Methods： We retrospectively reviewed 118 patients with lumbar disc herniation treated from 2012.06 to 2015.06. 46 patients received MD and 72 patients were given PELD. All patients received at least 6 months fellow up. Clinical outcomes were evaluated by operation time, the time in bed, blood loss, the length of incision,cost, lumbar vertebral function and complications and so on. Results： The VAS score and lumbar function of the patients were significantly better than pre-operation, but there was no difference between two groups. The time of operation and the time in bed and the cost of patients who had PELD was significantly better compared with those who had MD（P〈0.05）. There was no difference between two groups in the time in hospital, the blood loss, length of incision and the complication. Conclusions： MD and PELD as the micro-spine operation have obvious advantages and good safty in the treatment of lumbar disc herniation. They have the advantages and disadvantages respectively. It should be selected personality in clinic.

关 键 词：腰椎间盘突出症 椎间盘镜 椎间孔镜 

分 类 号：R681[医药卫生—骨科学]