经皮内镜治疗重度肥胖患者腰椎间盘突出症的临床疗效分析  

Clinical Analysis on Percutaneous Endoscopic Treatment for Lumbar Disc Herniation in Patients with Severe Obesity

作　　者：梁亮科[1] 禤天航 曹正霖[1] 关宏刚[1] 王鹏[1] 霍智铭[1] 陈超[1] 

机构地区：[1]佛山市中医院骨科,广东佛山528000

出　　处：《临床医学工程》2017年第6期759-761,共3页Clinical Medicine & Engineering

摘　　要：目的观察经皮椎间孔镜下治疗重度肥胖患者腰椎间盘突出的临床疗效。方法选择2012年1月到2015年1月符合纳入标准的60例患者随机分为两组各30例。治疗组患者接受经皮内镜下髓核摘除术(PELD),对照组患者接受椎板开窗内固定融合术(PLIF),两组患者在治疗后采用腿痛VAS、背痛VAS评分及改良型MacNab标准评价其手术疗效。结果两组患者末次随访的腿痛VAS、改良MacNab疗效比较无统计学差异(P>0.05),但治疗组在背痛VAS评分、手术时间、手术切口长度、失血量及住院时间方面与对照组比较具有显著优势(P<0.05)。结论 PELD与PLIF均是治疗重度肥胖患者腰椎间盘突出症的有效手段。但前者治疗该病更具微创性,术后腰痛症状出现几率更少。Objective To observe the clinical effect of percutaneous endoscopic discectomy for lumbar disc herniation in patients with severe obesity. Methods 60 patients who met the inclusion criteria from January 2012 to January 2015 were randomly divided into two groups equally. Patients in the treatment group were treated with percutaneous endoscopic lumbar discectomy （PELD）, and patients in the control group were treated with laminectomy and posterior lumbar interbody fusion （PLIF）. The surgical effects of two groups were evaluated by VAS score of leg pain, VAS score of back pain and modified MacNab criteria. Results At the final follow-up, no statistical difference was found between two groups in the VAS score of leg pain and efficacy of modified MacNab （P〉0.05）, while the treatment group had more significant advantages than the control group in the VAS score of back pain, operative time, surgical incision length, blood loss and hospitalization time （P〈0.05）. Conclusions Both PELD and PL1F are effective methods for the treatment of lumbar disc herniation in patients with severe obesity, but the former shows more minimally invasive treatment, fewer incidence of postoperative low back pain symptoms.

关 键 词：腰椎间盘突出症 重度肥胖 经皮内镜下髓核摘除术 内固定融合术 微创手术 

分 类 号：R681.5[医药卫生—骨科学]