经皮椎间孔镜下TESSYS技术配合中药内服治疗腰椎间盘突出症临床疗效观察  

Therapeutic Effect of TESSYS Technique of Percutaneous Transforaminal Endoscopic Discectomy Combined with Oral Use of Chinese Medicine for Lumbar Disc Herniation

作　　者：朱辉[1] 原超[1] 张文财[1] 林宏衡[1] ZHU Hui YUAN Chao ZHANG Wen-Cai LIN Hong-Heng(Orthopedie Hospital Affiliated to Guangzhou University of Chinese Medieine , Guangzhou510240Guangdong, China)

机构地区：[1]广州中医药大学附属骨伤科医院,广东广州510240

出　　处：《广州中医药大学学报》2017年第3期331-334,共4页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】观察侧路经皮椎间孔镜下TESSYS(transforaminal endoscopic spine system)技术配合中药内服治疗腰椎间盘突出症的临床疗效。【方法】采用侧路经皮椎间孔镜下TESSYS技术治疗39例腰椎间盘突出症患者,术后给予中药补肾壮督法为主的虚痹方加减内服4周,采用疼痛视觉模拟评分法(VAS)、Oswestry功能障碍指数(ODI)和改良Mac Nab标准评估患者术前、术后3 d、术后6个月的临床疗效。【结果】(1)39例患者均顺利完成手术,并获6~12个月随访。(2)术后3 d和术后6个月,患者VAS评分及ODI评分均显著低于术前,差异均有统计学意义(P<0.05)。(3)术后6个月,根据改良Mac Nab标准评定患者疗效,结果优良率达89.74%。(4)术后除4例患者出现一过性患侧肢体疼痛麻木加重外,无永久性神经根损伤、硬脊膜撕裂、血管损伤、肠管损伤、椎间盘炎及腹膜后血肿等并发症发生。【结论】侧路经皮椎间孔镜下TESSYS技术配合中药内服治疗腰椎间盘突出症患者,其近期疗效确切,具有出血少、创伤小、恢复快以及术后并发症少等优点。Objective To observe the clinical efficacy of the TESSYS （transforaminal endoscopic spine system ） technique of percutaneous transforaminal endoscopic discectomy combined with oral use of Chinese medicine for the treatment of lumbar disc herniation. Methods Thirty-nine patients with lumbar disc herniation were treated by the TESSYS technique of percutaneous transforaminal endoscopic discectomy, and then received oral use of modified herbal medicine Xubi Recipe, a formula mainly having the actions of tonifying kidney and strengthening governor vessel for 4 weeks after the operation. The visual analogue scale （VAS） and Oswestry disability index （ODI） and modified MacNab criteria were employed to assessed the surgical outcomes before the operation, and 3 and 6 months after the operation. Results （ 1 ） All of the 39 cases completed the operation successfully, and were followed up for 6-12 months after the operation. （2） Three and 6 months after the operation, the VAS scores and ODI scores were obviously lower than those before the operation, and the differences were significant （P 〈 0.05）. （3） Six months after the operation, the excellent rate of clinical efficacy assessed by modified MacNab criteria was 89.74%. （4） Only 4 eases had severer transient pain and numbness in the affected limbs, and there was no occurrence of complications of permanent neural root trauma, dural tear, vascular injury, intestinal damage, spondylodiscitis or retroperitoneal hematoma. Conclusion The TESSYS technique of percutaneous transforaminal endoscopic discectomy combined with oral use of Chinese medicine is effective for the treatment of the lumbar disc herniation with the advantages of satisfactory short-term effect, less bleeding, less trauma, faster recovery and less complications.

关 键 词：经皮椎间孔镜技术 TESSYS技术 虚痹方 补肾壮督 腰椎间盘突出症 

分 类 号：R681.53[医药卫生—骨科学] R274.9[医药卫生—外科学]