经皮椎间孔镜不同微创术式治疗腰椎间盘突出症的疗效观察  

Clinical Application and Study of Minimally Invasive Treatment of Lumbar Disc Herniation with Percutaneous Foramen

作　　者：陈辉[1] 牛国旗[1] 刘路坦 Chen Hui;Niu Guoqi;Liu Lutan(Department of Orthopaedics,Second Affiliated Hospital of Bengbu Medical College)

机构地区：[1]蚌埠医学院第二附属医院骨科,233000

出　　处：《长治医学院学报》2021年第2期121-125,共5页Journal of Changzhi Medical College

基　　金：2017年度蚌埠医学院科研课题(BYKY17124)。

摘　　要：目的:探讨经皮椎间孔镜不同微创术式治疗腰椎间盘突出症的临床疗效。方法:选择行经皮椎间孔镜微创手术(PELD)治疗的腰椎间盘突出症(LDH)患者108例,根据不同术式分为TESSYS组(n=48)、BEIS组(n=32)、Isee组(n=28),TESSYS组患者行经皮椎间孔镜TESSYS技术治疗,BEIS组患者行BEIS椎间孔镜术治疗,Isee组患者行可视化椎间孔成形技术治疗;比较3组术中情况(术中出血量、透视次数、透视时间、住院时间)及术后情况(VAS评分、ODI评分、JOA评分),比较3组治疗效果。结果:(1)3组临床优良率比较,Isee组(89.29%)高于BEIS组(75.00%)和TESSYS组(62.50%),差异有统计学意义(P<0.05)。(2)3组手术情况比较,TESSYS组手术时间长于Isee组、BEIS组,Isee组手术时间、术中出血量、透视次数、透视时间、住院时间均少于TESSYS组和BEIS组,且BEIS组少于TESSYS组,差异有统计学意义(P<0.05)。(3)术后3个月Isee组VAS、ODI评分低于TESSYS组和BEIS组,BEIS组低于TESSYS组;Isee组JOA评分高于BEIS组和TESSYS组,BEIS组高于TESSYS组,差异有统计学意义(P<0.05)。(4)术后3个月Isee组坐骨神经、股神经传导速度快于TESSYS组和BEIS组,BEIS组快于TESSYS组,差异有统计学意义(P<0.05)。结论:Isee技术在LDH中的治疗具有操作简便、手术时间短、放射暴露少等优点,可明显改善患者术后腰椎功能,减轻临床症状,提高坐骨神经及股神经的神经传导速度。Objective:To investigate the clinical effect of different minimally invasive percutaneous foramen in the treatment of lumbar disc herniation.Methods:108 patients with LDH who underwent minimally invasive percutaneous foramen were selected and divided into tessys group(n=48),beis group(n=32)and Isee group(n=28).The patients in the tessys group were treated with transdermal foraminal microsurgery,the patients in the beis group were treated with beis,and the patients in the Isee group were treated with visualized foraminal plasty.The intraoperative conditions(intraoperative blood floss,fluoroscopy times,fluoroscopy time,length of hospitalization)and postoperative conditions(VAS score,ODI score,JOA score)were compared among the three groups,and the treatment effects of the three groups were compared.Results:(1)Comparison of clinical excellent and good rate,Isee group(89.29%)was higher than that in tessys group(75.00%)and beis group(62.50%),and beis group was higher than essys group,the difference was statistically significant(P<0.05);(2)In comparison of surgical conditions,the intraoperative blood loss,times of operation,times of fluoroscopy,time of penetration and length of stay in the Isee group were Iess than those of the tessys group and beis group,and the different was statistically significant(P<0.05);(3)Three months after surgery,VAS and ODI scores in Isee group were lower than those in tessys group and beis group,and beis group was lower than the tessys group;JOA score in isee group was higher than that in tessys group and beis group,beis group was higher than the tessys group,and the difference was statistically significant(P<0.05);(4)Three months after operation,the conduction velocity of sciatic nerve and femoral nerve in Isee group was faster than that in tessys group and beis group,and the beis group was faster than that in tessys group,and the difference was statistically significant(P<0.05).Conclusion:Isee technology has more obvious advantages in the treatment of LDH.It has the advantages of simple op

关 键 词：腰椎间盘突出症 经皮椎间孔镜微创手术 TESSYS手术 BEIS手术 Isee手术 

分 类 号：R681.3[医药卫生—骨科学]