经皮椎间孔镜技术治疗退变性腰椎管狭窄症74例临床应用体会  

Percutaneous transforaminal endoscopic discectomy technique for treatment of degenerative lumbar spinal stenosis:Report of 74 clinical cases

作　　者：聂邦旭[1] 袁晓峰[1] 余林薪[1] 卞鸿燕[1] 蔡云华 胡军[1] 张金 Nie Bangxu;Yuan Xiaofeng;Yu Linxin;Bian Hongyan;Cai Yimhua;Hu Jun;Zhang Jin(The 1st People's Hospital of Kunming City,Kunming Yunnan,650011,China)

机构地区：[1]昆明市第一人民医院,云南昆明650011

出　　处：《生物骨科材料与临床研究》2021年第4期59-61,66,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨经皮椎间孔镜技术治疗退变性腰椎管狭窄症的临床疗效。方法对2015年7月至2017年3月昆明市第一人民医院收治的74例腰椎管狭窄症患者进行经皮椎间孔镜手术治疗,采用疼痛视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI评分)评估临床疗效。结果手术时间为70~150 min,出血量10~40 m L,住院时间3~8 d,未发生严重并发症。术后平均随访36天。术前VAS评分为(6.96±0.74)分,术后1 d、1周、1个月VAS评分为(3.13±0.63)分、(2.44±0.87)分、(2.15±0.75)分。术前ODI评分为(39.07±11.58)分,术后1 d、1周、1个月ODI评分为(19.88±6.39)分、(18.75±5.84)分、(15.21±5.21)分。术后VAS评分及ODI评分较术前均显著改善,差异具有统计学意义(P<0.05)。结论经皮椎间孔镜技术治疗退变性腰椎管狭窄症具有创伤小、出血少、并发症少的优势,近期临床疗效满意。Objective To study the clinical effect of percutaneous transforaminal endoscopic discectomy technique in the treatment of degenerative lumbar spinal stenosis.Methods A total of 74 patients with degenerative lumbar spinal stenosis were treated by percutaneous transforaminal endoscopic discectomy during July 2015 to March 2017 in the 1 st People’s Hospital of Kunming City.The visual analogue scale(VAS)and Oswestry disability index(ODI)were used to evaluate the degree of pain and the clinical efficacy in each patient before and after operation.Results The operation time was 70 to 150 min,the blood loss was 10 to 40 m L,and the hospital stay was 3 to 8 days without serious complications.All patients were followed up for an average of 36 days after surgery.The preoperative VAS score was(6.96±0.74)points,and the VAS scores were(3.13±0.63),(2.44±0.87)and(2.15±0.75)points at 1 day,1 week,and 1 month after operation.The preoperative ODI score was(39.07±11.58)points,and the ODI scores were(19.88±6.39)points,(18.75±5.84)points,and(15.21±5.21)points at 1 day,1 week,and 1 month after operation.The postoperative VAS score and ODI score were significantly improved compared with that before operation,and the difference was statistically significant(P<0.05).Conclusion Percutaneous intervertebral foraminal technology in the treatment of de generative lumbar spinal stenosis has the advantages of less trauma,less bleeding and fewer complications,and the short-term clinical effect is satisfactory.

关 键 词：腰椎管狭窄症 退变 椎管减压 经皮椎间孔镜技术 微创 

分 类 号：R681.5[医药卫生—骨科学]