经皮椎间孔镜腰椎间盘切除术与椎板开窗腰椎间盘切除术治疗腰椎间盘突出症的效果比较  

Comparison of effects of percutaneous discectomy versus laminectomy in the treatment of lumbar disc herniation

作　　者：牛燕红 冯涛 宋亮 Niu Yanhong;Feng Tao;Song Liang(Department of Orthopaedics,Peking Medical Lu’an Hospital,Changzhi 046204,China)

机构地区：[1]北大医疗潞安医院骨科,山西长治046204

出　　处：《中国实用医刊》2020年第14期55-58,共4页Chinese Journal of Practical Medicine

摘　　要：目的:比较经皮椎间孔镜腰椎间盘切除术(PELD)与椎板开窗腰椎间盘切除术(LWF)治疗腰椎间盘突出症(LDH)的效果。方法:抽取北大医疗潞安医院2017年1月至2019年1月接诊的94例LDH患者,随机分为对照组47例和观察组47例。对照组患者采用LWF治疗,观察组患者采用PELD治疗。比较两组手术情况、临床治疗效果、生活质量、并发症、疼痛评分。结果:观察组优良率(93.62%)略高于对照组(85.11%),但差异未见统计学意义(P>0.05);观察组手术切口、术后卧床时间、术中出血量均低于对照组(P均<0.05);治疗后1、3、6个月观察组视觉模拟评分法(VAS)评分均低于对照组(P均<0.05);对照组不良反应发生率(14.89%)高于观察组(4.26%),但差异未见统计学意义(P>0.05)。结论:PELD治疗LDH治疗效果确切、创伤小、恢复快,可显著改善患者疼痛,减少术后不良并发症的发生率,值得推广使用。Objective To compare the therapeutic effect of lumbar disc protrusion(LDH)by percutaneous endoscopic lumbar discectomy(PELD)and laminectomy with fenestration(LWF).Methods A total of 94 patients with LDH in Peking Medical Lu’an Hospital from January 2017 to January 2019 were enrolled,and they were randomly divided into two groups,each with 47 cases.Control group received LWF,while observation group received PELD.Then the surgical conditions,clinical efficacy,pain score,quality of life,and complications were compared between the two groups.Results The excellent rate in the observation group was slightly higher than that in the control group,but the difference was not statistically significant(93.62%vs.85.11%,P>0.05);the surgical incision length,intraoperative blood loss,and postoperative bed rest time in the observation group were better than those in the control group(P<0.05).The visual analogue scale(VAS)scores at postoperative 1,3,and 6 months in the observation group were lower than those in the control group(P<0.05).The incidence of adverse reactions in the control group was higher than that in the observation group,but the difference was not statistically significant(14.89%vs.4.26%,P>0.05).Conclusions PELD can improve the pain of patients and reduce the incidence of postoperative complications.It is worth popularizing.

关 键 词：经皮椎间孔镜腰椎间盘切除术 腰椎间盘突出 

分 类 号：R687.3[医药卫生—骨科学]