腰椎PETD与PEID治疗腰椎间盘突出症疗效对比  

Therapeutic effects of lumbar PETD and PEID techniques in the treatment of lumbar disc herniation

作　　者：王放[1] 李杰[1] 孙宏[1] 李锋涛[1] 王栋[1] 李浩鹏[1] 贺西京[1] WANG Fang;LI Jie;SUN Hong;LI Fengtao;WANG Dong;LI Haopeng;HE Xijing(The Second Department of Orthopaedics,The Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China)

机构地区：[1]西安交通大学第二附属医院骨二科,陕西西安710004

出　　处：《西部医学》2020年第12期1773-1777,共5页Medical Journal of West China

基　　金：国家自然科学基金(81701223);陕西省自然科学基金(2017JQ8019);中央高校基本科研业务费专项资金资助(1191329737)。

摘　　要：目的对比经皮椎间孔入路椎间盘切除术(PETD)与经皮椎板间入路椎间盘切除术(PEID)治疗腰椎间盘突出症(LDH)的临床疗效。方法回顾性分析2016年10月~2019年1月我院因LDH行手术治疗的82例患者为研究对象,按手术方式分为PETD组(n=42)与PEID组40(n=40)。比较两组的围手术期情况(失血量、透视次数、手术时间、住院时长、有无并发症情况等),记录术前及末次随访时疼痛视觉模拟评分(VAS),Oswestry功能障碍指数(ODI)以及改良MacNab标准评价两组患者的临床疗效。结果两组患者性别、年龄、病程、随访时间、住院日及改良MacNab标准优良率比较,差异无统计学意义(P>0.05)。与术前相比,两组末次随访VAS评分和ODI指数均有明显改善(均P<0.05)。PETD组透视次数及手术时间大于PEID组(P<0.05)。术后随访,两组各有1例翻修,两组手术相关并发症、翻修率比较,差异无统计学意义(P>0.05)。结论腰椎PETD与PEID对LDH均有确切疗效,但PEID可明显减少术中透视次数,节约手术时间,具有一定的临床实用优势。Objective To compare the clinical efficacy in the treatment of lumbar disc herniation(LDH)between percutaneous endoscopic transforaminal discectomy(PETD)and percutaneous endoscopic interlaminar discectomy(PEID).Methods 82 patients with LDH in our hospital from October 2016 to January 2019 were retrospectively analyzed and divided into PETD group(n=42)and PEID group(n=40).The perioperative conditions(blood loss,fluoroscopy times,operation time,length of stay,complications,etc.)of the two groups were compared.The visual analogue scale(VAS),Oswestry disability index(ODI)and modified macnab criteria were recorded before and at the last follow-up to evaluate the clinical efficacy of the two groups.Results There was no significant difference in gender,age,course of disease,follow-up time,length of stay and excellent and good rate of modified MacNab standard between the two groups(P>0.05).The VAS score and ODI index in the last follow-up of the two groups were significantly improved compared with those before operation(all P<0.05).The times of fluoroscopy and operation time in PETD group were longer than those in PEID group(P<0.05).There was no significant difference in operation related complications and revision rate between the two groups(P>0.05).Conclusion Both lumbar vertebrae PTED and PTID have a definite effect on LDH,but PEID can significantly reduce the number of intraoperative fluoroscopy and save operation time.

关 键 词：经皮椎间孔入路椎间盘切除术 经皮椎板间入路椎间盘切除术 腰椎间盘突出症 疗效 

分 类 号：R681.5[医药卫生—骨科学]