经皮椎间孔镜椎间盘切除术与开窗减压髓核摘除术治疗单节段腰椎间盘突出症临床效果对比研究  

Comparative study on the clinical effect of PTED and ODD in treatment of single-segment lumbar disc herniation

作　　者：常龙 张晨[2] 张佳林[1] 付斌[1] 夏根[1] 陈德胜[1] CHANG Long;ZHANG Chen;ZHANG Jialin;FU Bin;XIA Gen;CHEN Desheng(Department of Orthopedics,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院骨科,宁夏银川750004 [2]宁夏医科大学研究生院,宁夏银川750004

出　　处：《陕西医学杂志》2021年第3期289-292,共4页Shaanxi Medical Journal

基　　金：国家自然科学基金资助项目(81760405,81760395,81560364);宁夏回族自治区自然科学基金资助重点项目(2018AAC02013);宁夏医科大学校级科研重点资助项目(XZ2018014)。

摘　　要：目的:比较经皮椎间孔镜椎间盘切除术(PTED)与开窗减压髓核摘除术(ODD)治疗腰椎间盘突出症(LDH)的临床治疗效果。方法:选取186例LDH患者,按不同手术方式分为PTED组(114例)和ODD组(75例)。比较两组患者手术时间、术中出血量、术后下床时间、脊柱Oswestry功能障碍指数(ODI)评分、日本腰椎矫形外科学会脊柱功能(JOA)评分、视觉模拟量表(VAS)评分以及住院满意度评分。结果:PTED组手术时间长于ODD组,术中出血量及术后下床时间均端于ODD组,术后3、6个月ODI评分均低于ODD组,术后3、6个月JOA评分均高于ODD组,术后3个月VAS评分明显低于ODD组,住院满意度评分高于ODD组(均P<0.05)。结论:相较于开窗减压髓核摘除术,经皮椎间孔镜椎间盘切除术在治疗腰椎间盘突出症中疗效更显著,创伤更小,患者术后恢复更快,腰椎功能改善更明显。Objective:To compare the clinical effects of percutaneous transforaminal endoscopic discectomy(PTED)and open decompression discectomy(ODD)in the treatment of lumbar disc herniation(LDH).Methods:186 patients with LDH were selected and divided into PTED group(114 cases)and ODD group(75 cases)according to different surgical procedures.The operation time,intraoperative blood loss,time of getting out of bed after operation,ODI score,JOA score,VAS score,hospitalization satisfaction were compared between the two groups.Results:The operation time of the PTED group was longer than that of the ODD group,and the intraoperative blood loss and the time of getting out of bed after operation were lower than those of the ODD group,and the ODI scores at 3 months and 6 months after operation were lower than those of the ODD group,and the JOA scores at 3 months and 6 months after operation were higher than those of ODD group,and the VAS score at 3 months after operation was significantly lower than that of the ODD group,and the hospitalization satisfaction score was higher than that of the ODD group(all P<0.05).Conclusion:Compared with open decompression discectomy,percutaneous transforaminal endoscopic discectomy is more effective in the treatment of lumbar disc herniation,with less trauma,faster postoperative recovery and more obvious improvement of lumbar function.

关 键 词：腰椎间盘突出症 经皮椎间孔镜椎间盘切除术 开窗减压髓核摘除术 OSWESTRY功能障碍指数 视觉模拟量表 对比研究 

分 类 号：R681.5[医药卫生—骨科学]