后路椎间盘镜技术(MED)与经皮椎间孔镜技术(PTED)治疗腰椎间盘突出症的临床疗效对比观察  

Clinical observation of MED and PTED in the treatment of lumbar disc herniation

作　　者：张志强[1] 蔡俊[1] 张圣飞[1] 张亮[1] 黄吉军[1] 吴朗[1] 杨建东[1] 冯新民[1] ZHANG Zhi-qiang;CAI Jun;ZHANG Sheng-fei(Orthopedic spine,Subei People′s Hospital of Jiangsu,Yangzhou 225800,China)

机构地区：[1]江苏省苏北人民医院骨科脊柱

出　　处：《吉林医学》2019年第7期1463-1466,共4页Jilin Medical Journal

基　　金：扬州市自然科学基金资助[项目编号:YZ2017116]

摘　　要：目的:比较后路椎间盘镜技术(MED)与经皮椎间孔镜技术(PTED)治疗单节段腰椎间盘突出症的临床疗效。方法:选取PTED单节段腰椎间盘突出症患者112例,接受MED治疗48例(MED组),接受PTED64例(PTED组),记录两组患者的手术时间、住院天数、住院费用、并发症发生率。应用疼痛视觉模拟评分(VAS评分)及改良Macnab标准评价术后临床疗效。结果:MED组的住院天数与PTED组比较,差异无统计学意义(P>0.05);MED组手术时间及住院费用比PTED组少,差异有统计学意义(P<0.05);两组并发症发生率分别为4.17%和6.25%,差异无统计学意义(P>0.05)。两组术前VAS评分比较、术后VAS评分比较差异无统计学意义(P>0.05),但两组术后VAS组内评分与术前比较,有明显改善,差异有统计学意义(P<0.01);术后3个月改良Macnab标准评定优良率,MED组与PTED组分别为91.67%和89.06%,差异无统计学意义(P>0.05)。结论:MED与PTED治疗腰椎间盘突出症均能取得良好地手术效果,PTED技术优于MED技术。但在开展PTED手术早期,需要选择合适病例,严格把握手术适应证,努力提高手术技术。Objective To retrospective analyze the clinical effect of MED and PTED for the treatment of LDH. Method112 patients with single-level lumbar disc herniation underwent discoscopic surgery in 48 cases and endoscopic surgery in 64 cases.The operation time,hospitalization days,hospitalization expenses and complications were recorded.Pain visual analogue scale (VAS score) and modified Macnab criteria were used to evaluate postoperative clinical efficacy. Results There was no significant difference between the hospitalization days of MED group and PTED group ( P >0.05);the operation time and hospitalization expenses of MED group were less than those of PTED group ( P <0.05);the incidence of complications was 4.17% and 6.25% respectively,and there was no significant difference between the two groups ( P >0.05).There was no significant difference between MED group and PTED group in VAS score before operation and VAS score after operation ( P >0.05),but VAS score after operation was significantly improved in both groups ( P <0.01),and the excellent and good rate of modified Macnab criterion at 3 months after operation was 91.67%(MED) and 89.06%(PTED),respectively.Meaning ( P > 0.05). Conclusion MED and PTED can achieve good results in the treatment of lumbar disc herniation,and PTED is superior to MED.However,in the early stage of PTED,it is necessary to select appropriate cases,strictly grasp the surgical indications,and strive to improve the surgical techniques.

关 键 词：腰椎间盘突出症 微创手术 髓核摘除术 椎间孔镜 椎间盘镜 

分 类 号：R687.3[医药卫生—骨科学]