PEID与MED治疗单侧L5/S1椎间盘突出症疗效分析  

Analysis of efficacy of PEID and MED in the treatment of unilateral L5/S1 disc herniation

作　　者：丁俊峰 张贤[2] Ding Junfeng;Zhan Xian(Nanjing University of Traditional Chinese Medicine,Nanjing Jiangsu,210000, China;Wuxi Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine, Wuxi Jiangsu,214000, China)

机构地区：[1]南京中医药大学,江苏南京210000 [2]南京中医药大学附属无锡市中医医院,江苏无锡214000

出　　处：《中外女性健康研究》2021年第8期171-174,共4页Women＇s Health Research

摘　　要：目的探讨经椎板间入路椎间孔镜(percutaneous endoscopic interlaminar discectomy PEID)与椎间盘镜(microendoseopic discectomy MED)下治疗单侧L5/S1椎间盘突出症早中期疗效对比。方法采用回顾性分析,将2018年1月至2019年1月于无锡市中医医院脊柱科L5/S1单侧腰椎间盘突出症行PEID(24例)和MED(23例)手术患者临床资料进行对比研究,并获得(11.9±1.3)月随访。观察患者手术时间、术中出血量、术中X线照射次数、手术切口和平均住院时间;选取术前、术后、术后3个月及12个月时间点,利用视觉模拟评分方法(VAS)进行腰腿痛程度评估;采用功能障碍Oswestry指数(ODI)于术前、术后1年进行腰椎活动功能评定;术后1年时,采用改良MacNab标准进行疗效评定分为优、良、可、差4个等级。结果PEID组患者手术时间、术中出血量、手术切口、平均住院时间均优于MED组(P<0.05);两组术中X线照射次数相比无统计学差异(P>0.05);PEID组和MED组组内患者术后随访时间点腰腿痛的VAS评分较术前均有明显改善,有统计学差异(P<0.05),并且PEID组和MED组组间相比,PEID组术后的VAS评分低于MED组(P<0.05);PEID组和MED组组间ODI评分在术后12月比较差异无统计学意义(P>0.05)。按照改良MacNab疗效评定标准,PEID组优良率为95.8%,MED组优良率95.6%,两组无统计学差异(P>0.05)。结论PEID与MED治疗L5/S1单侧腰椎间盘突出症早期疗效相当,但PEID在术中出血量、手术切口长度以及平均住院时间等方面更具微创优势。Objective:To investigate the early and medium term efficacy of PEID versus MED in the treatment of unilateral L5/S1 disc herniation.Methods:Retrospective analysis was performed to compare the clinical data of patients with L5/S1 unilateral lumbar disc herniation treated by PEID(24 cases)and MED(23 cases)from January 2018 to January 2019 in the Department of Spine,Wuxi Hospital of Traditional Chinese Medicine,and(11.9±1.3)months follow-up was obtained.The operative time,intraoperative blood loss,frequency of intraoperative X-ray exposure,surgical incision and average length of hospital stay were observed.VAS was used to evaluate the degree of lumbar and leg pain before,after,3 months and 12 months after surgery.Lumbar motor function was assessed by the ODI before and 1 year after surgery.At 1 year after surgery,the efficacy was evaluated using the modified MacNAB standard,which was divided into four grades:excellent,good,fair and poor.Results:The operative time,intraoperative blood loss,surgical incision and average length of hospital stay in PEID group were better than those in MED group(P<0.05).There was no statistical significance in the number of intraoperative X-ray irradiation between the two groups(P>0.05).The VAS scores of patients in the PEID group and the MED group at the time of postoperative follow-up were significantly improved compared with those before surgery,with statistical significance(P<0.05).Compared with the MED group and the PEID group,the postoperative VAS scores of the PEID group were lower than those of the MED group(P<0.05).There was no significant difference in ODI scores between the PEID group and the MED group 12 months after surgery(P>0.05).Conclusion:PEID has the same early efficacy as MED in the treatment of unilateral lumbar disc herniation in L5/S1,but PEID has more minimally invasive advantages in terms of intraoperative blood loss,incision length and average length of hospital stay.

关 键 词：腰椎间盘突出症 椎间孔镜 椎间盘镜 椎板间入路 

分 类 号：R681.5[医药卫生—骨科学]