后路椎间盘镜髓核摘除术治疗单节段腰椎间盘突出症的效果观察  

Effect of posterior microendoscopic discectomy on patients with single segment lumbar disc herniation

作　　者：王家启 李家俊 李璐 Wang Jiaqi;Li Jiajun;Li Lu(Department of Interventional Medicine,Liaocheng Traditional Chinese Medicine Hospital,Liaocheng 252000,China;Department of Pediatric Orthopedics,Liaocheng Traditional Chinese Medicine Hospital,Liaocheng 252000,China;Department of Anesthesiology,Liaocheng Traditional Chinese Medicine Hospital,Liaocheng 252000,China)

机构地区：[1]山东省聊城市中医医院介入科,252000 [2]山东省聊城市中医医院小儿骨科,252000 [3]山东省聊城市中医医院麻醉科,252000

出　　处：《中国实用医刊》2021年第3期96-99,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨后路椎间盘镜髓核摘除术(MED)对单节段腰椎间盘突出症(LDH)患者腰椎功能的影响。方法抽取2017年1月至2019年1月聊城市中医医院收治的80例单节段LDH患者,采用随机数字表法将其分为两组,每组40例。对照组采用椎板间开窗髓核摘除术(FD)治疗,观察组采用MED治疗,均随访至术后1年。比较两组临床指标、腰椎功能、疼痛程度及并发症发生情况。结果观察组手术时间、卧床时间、住院时间及切口长度分别为(49.51±12.72)min、(3.47±1.18)d、(7.07±3.45)d、(2.29±0.39)cm,均短于对照组的(58.28±14.86)min、(4.87±1.23)d、(10.85±4.02)d、(5.59±0.58)cm,P<0.05;观察组术中出血量为(52.73±10.89)ml,少于对照组的(77.72±15.67)ml,差异有统计学意义(P<0.05)。术后1年,两组日本骨科学会(JOA)评分均高于术前,视觉模拟评分法(VAS)评分均低于术前,且观察组JOA评分高于对照组,VAS评分低于对照组(P<0.05)。两组术后并发症发生率比较差异未见统计学意义(P>0.05)。结论单节段LDH患者采用MED治疗的创伤较小,可改善腰椎功能,缓解疼痛,促进术后恢复,且有一定的安全性。Objective To investigate the effects of posterior microendoscopic discectomy(MED)on lumbar function in patients with single segment lumbar disc herniation(LDH).Methods A total of 80 patients with single segment LDH admitted to Liaocheng Traditional Chinese Medicine Hospital from January 2017 to January 2019 were selected.Patients were divided into two groups by random number table method,with 40 cases in each group.The control group was treated by fenestration discectomy(FD),while the observation group was treated by MED.All patients were followed up for 1 year after surgery.Clinical indicators,lumbar function,pain degree and complications were compared between the two groups.Results The operative time,bed rest time,hospital stay,and incision length of the observation group were(49.51±12.72)min,(3.47±1.18)d,(7.07±3.45)d,(2.29±0.39)cm,respectively,shorter than the(58.28±14.86)min,(4.87±1.23)d,(10.85±4.02)d,(5.59±0.58)cm of the control group(P<0.05).And the intraoperative blood loss of the observation group was(52.73±10.89)ml,less than the(77.72±15.67)ml of the control group(P<0.05).One year after surgery,the Japanese Orthopaedics Association(JOA)scores in both groups were higher than those before surgery,and visual analogue scale(VAS)scores,were lower than those before surgery(P<0.05).Compared with the control group,JOA score was higher,and VAS score was lower in the observation group(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusions In patients with single segment LDH,MED has less trauma;and it can improve lumbar function,relieve pain,promote postoperative recovery,and has certain safety.

关 键 词：腰椎间盘突出症 后路椎间盘镜髓核摘除术 

分 类 号：R687.3[医药卫生—骨科学]