经皮椎间孔镜治疗腰椎间盘突出症的临床效果  

Clinical effect of percutaneous endoscopic lumbar discectomy for lumbar disc herniation

作　　者：符祖昶[1] 王清铿 尤瑞金[1] 周潘宇[2] 

机构地区：[1]解放军第180医院骨科19病区,福建泉州362000 [2]第二军医大学附属长海医院骨科,上海200433

出　　处：《中国医药导报》2017年第18期80-83,共4页China Medical Herald

基　　金：国家自然科学基金资助项目(81601910)

摘　　要：目的探讨经皮椎间孔镜腰椎间盘切除术(PELD)治疗腰椎间盘突出症的临床效果。方法选择2013年1月~2016年1月解放军第180医院收治的126例腰椎间盘突出症患者,采用随机数字表法分为观察组和对照组,每组各63例。观察组行PELD,对照组行椎板开窗腰椎间盘切除术,术后随访12个月。比较两组患者手术切口长度、手术时间、术中出血量及住院时间,并用疼痛视觉类比评分(VAS)、Oswestry功能障碍指数(ODI)与改良MacNab标准来评定手术效果。结果观察组的切口长度、术中出血量及住院时间均小于对照组,差异有统计学意义(P<0.05)。术后两组患者的VAS与ODI均较术前改善,但观察组的改善程度优于对照组,差异有统计学意义(P<0.05)。两组术后改良MacNab标准评价疗效,观察组优于对照组,差异有统计学意义(P<0.05)。结论应用PELD治疗腰椎间盘突出症能减少术中出血量,减小手术切口,缩短住院时间,提高手术疗效,改善患者术后生活质量,值得临床推广。Objective To observe the clinical effect of percutaneous endoscopic lumbar discectomy（PELD） in the treatment of patients with lumbar disc herniation. Methods From January 2013 to January 2016, in 180 Hospital of PLA,126 patients with lumbar disc herniation were divided into two groups according to the random number table, with 63 cases in each group. The observation group was given PELD, the control group was given fenestration discectomy, they were followed up for 12 months. The operative incision length, operation time, hemorrhage volume and hospitalization days of two groups were compared. The clinical outcome were evaluated by visual analogue score（VAS）, Oswestry disability index（ODI） and modified MacNab standard. Results Operative incision length, hemorrhage volume and hospitalization days in observation group was significantly less than control group, the differences were statistically significant（P〈0.05）. The ODI and VAS of two groups were improved after operation, and the improvement in observation group was significantly more obvious than control group, the differences were statistically significant（P〈0.05）. The curative effect evaluated modified MacNab standard of observation group was better than control group, the difference was statistically significant（P〈0.05）. Conclusion The application of PELD in the treatment of lumbar disc herniation can reduce hemorrhage volume, decrease operative incision length, shorten operation time, improve treatment efficacy and improve patients, quality of life. It is worth of clinical promotion.

关 键 词：腰椎间盘突出症 经皮椎间孔镜 微创手术 椎间盘切除术 

分 类 号：R687.3[医药卫生—骨科学]