经皮椎间孔镜髓核摘除与quadrant通道下椎间融合减压内固定治疗腰椎退行性病变疗效及对围术期和并发症的影响  

Curative Effect of Percutaneous Transforaminal Endoscopic Discectomy and Interbody Fusion Decompression and Internal Fixation Under Quadrant Channel in the Treatment of Lumbar Degenerative Disease and the Influence on Perioperative Period and Complications

作　　者：崔显峰 都嘉明 丁鑫 CUI Xianfeng;DU Jiaming;DING Xin(Liaoyang Central Hospital, Liaoning Liaoyang 111000, China)

机构地区：[1]辽宁省辽阳市中心医院骨科,辽宁辽阳111000

出　　处：《河北医学》2021年第10期1666-1670,共5页Hebei Medicine

基　　金：辽宁省自然科学基金计划项目,(编号:2019-MS-370)。

摘　　要：目的:探究经皮椎间孔镜下髓核摘除术(Percutaneous transforaminal endoscopic discectomy,PTED)与quadrant通道下椎间融合减压内固定治疗对腰椎退行性病变患者的治疗疗效,以及对患者围术期恢复以及并发症的影响。方法:选取2016年1月至2020年7月在本院接受治疗的腰椎退行性病变患者150例,采用简单随机分组,分为观察组(76例)和对照组(74例)。其中对照组采用PTED治疗,观察组患者采用quadrant通道下椎间融合减压内固定治疗,对比相关参数。结果:观察组手术时间较对照组长(P<0.05),术后引流、手术出血量、切口长度、尿路感染、尿潴留、肠梗阻、深静脉血栓并发症发生率小于对照组(P<0.05),住院时间较短(P<0.05);术后第1、3d以及术后3个月,观察组患者的视觉模拟评分法(Visual analogue scale,VAS)低于对照组(P<0.05),术后6个月无差异(P>0.05);术后3个月,观察组的腰痛评分标准(The Oswestry Disability Index,ODI)小于对照组(P<0.05),术后6个月无差异(P>0.05);术后3个月,观察组患者的生活质量综合评定问卷(Generic quality of life inventory,GQOL-74)评分高于对照组(P<0.05)。结论:quadrant通道下椎间融合减压内固定治疗的手术时间更长,但可显著改善腰椎退行性病变患者预后,降低疼痛和并发症,显著改善患者的生活质量以及腰功能,加快患者术后恢复。Objective:To explore the therapeutic effects of percutaneous transforaminal endoscopic discectomy(PTED)and interbody fusion decompression and internal fixation under Quadrant channel in the treatment of lumbar degenerative disease,and the influence on perioperative period and complications.Methods:150 patients with lumbar degenerative disease treated in the hospital between January 2016 and July 2020 were selected and randomly divided into observation group(76 cases)and control group(74 cases).The control group was treated with PTED,and the observation group was treated with interbody fusion decompression and internal fixation under Quadrant channel.Related parameters were compared.Results:The operation time of the observation group was longer than that of the control group(P<0.05).The postoperative drainage volume,intraoperative blood loss,length of incision,the incidences of urinary tract infection,urinary retention,intestinal obstruction and deep vein thrombosis,and the length of hospital stay in the observation group were less,shorter or lower than those in the control group(P<0.05).The visual analogue scale(VAS)scores of the observation group were lower than those of the control group on the 1st and 3rd days after operation,and at 3 months after operation(P<0.05).There was no difference at 6 months after operation(P>0.05).3 months after operation,the low back pain score(Oswestry Disability Index,ODI)of the observation group was lower than that of the control group(P<0.05),but there was no difference at 6 months after operation(P>0.05).3 months after operation,the generic quality of life inventory(GQOL-74)score of the observation group was higher than that of the control group(P<0.05).Conclusion:The duration of interbody fusion decompression and internal fixation under Quadrant channel is longer,but it can significantly improve the prognosis of patients with lumbar degenerative disease,reduce pain and complications,significantly improve the patients’quality of life and lumbar function,and promote postoperat

关 键 词：腰椎退行性病变 quadrant通道下椎间融合减压内固定 经皮椎间孔镜髓核摘除 疼痛 并发症 

分 类 号：R47[医药卫生—护理学]