应用椎间盘镜与椎板开窗行单节段髓核摘除术的疗效分析  

The Effect of MED and FD in the Treatment of Single Segment Nucleus Pulposus Removal

作　　者：伊力夏提·赛吾来提 帕力哈提·白克吐尔逊 YI Lixiati SAI Wulaiti PAR Hat BAI Ketuerxun(Department of second orthopeadic , Yili friendship hospital, Yili, Xingjiang, 83000)

机构地区：[1]伊犁州友谊医院骨外二科,新疆伊犁835000

出　　处：《中国伤残医学》2016年第17期2-4,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：比较应用椎间盘镜（ Microendoscopic Discectomy ， MED）与椎板开窗（ Fanestration Discectomy ， FD）髓核摘除术在治疗单节段腰椎间盘突出症（ Lumbar Disc Herniation ， LDH）的临床疗效。方法：回顾性分析2011年6月～2013年6月，我院97例单节段性LDH患者行髓核摘除手术的患者为研究对象，其中行MED65例，FD32例，获得如年龄、性别、术中出血量、手术时间等信息，并随访分析。结果：MED组术中出血量较FD组少，差异有统计学意义（P＜0．05），FD组手术时间较MED组较短，差异有统计学意义（P＜0．05）。术中相关并发症（硬膜囊破裂、神经根损伤）比较，差异无统计学意义（P＞0．05）。随访时间6个月～4年，17例失访，失访率为17．89％。随访不同阶段，MED术后并发症发生率明显低于FD组，差异有统计学意义（ P＜0．05），术后JOA优良率术后1周和术后6周，MED组要高于FD组，差异有统计学意义（P＜0．05）。但在术后6个月JOA优良率及随访终末期术后复发率的比较中，2组差异不显著（ P＞0．05）。结论：MED可以有效缓解单阶段LDH症状，术后并发症发生率较FD低，值得临床参考应用。Obj ective：To compare the clinical effect of MED（ Microendoscopic Discectomy ） and FD（ Fanestration Discectomy） nucle-us pulposus removal in the treatment of single segment LDH .Methods：Retrospective analysis from June 2011 to June 2013, 97 patients with single segmental LDH in our hospital ,who underwent nucleus pulposus removal were the study object , there were 65 cases in MED group and 32 cases in FD group, Information such as age, sex, blood loss, operation time and so on were collected and analyzed .Re-sults：The amount of bleeding in MED group was less than that of FD group , and the difference was statistically significant （P〈0.05）, and the operation time of FD group was shorter than that of MED group , and the difference was statistically significant （P〈0.05）.The intraoperative related complications （ dural capsule rupture , nerve root damage ） were compared , and there were no significant differences （ P〉0.05）.The follow-up period was 6 months -4 years, 17 cases were lost, the rate of loss was 17.89%.Different stages of follow-up, Med postoperative complication rate was significantly lower in FD group , differences were statistically significant （P 〈0.05）. Postoperative JOA excellent operation rate after operation and 1 week after 6 weeks, the Med group to group was higher than that of FD , the difference is statistically significant （P 〈0.05）.However, in the 6 months after surgery, the excellent and follow -up of JOA and the recurrence rate after the end of the surgery , the difference between the two groups was not significant （P〉0.05）.Conclusion：MED can effectively relieve the symptoms of single stage LDH , and the incidence of postoperative complication is lower than that of FD , which is worthy of clinical reference .

关 键 词：椎间盘镜 椎板开窗 腰椎间盘突出症 

分 类 号：R681.5[医药卫生—骨科学]