Delta和MED治疗退行性腰椎管狭窄症的比较  

Comparison of DELTA and MED in the Treatment of Degenerative Lumbar Spinal Stenosis

作　　者：张鹏 刘丰平 刘扬[1,2] 赵红卫 Zhang Peng;Liu Fengping;Liu Yang;Zhao Hongwei(Department of Emergency Intensive Care Medicine,Xiangyang Central Hospital,Affiliated Hospital of Hubei University of Arts and Science,Xiangyang 441021,China;Department of Spine Surgery,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University&Institute of Spine and Trauma,China Three Gorges University,Yichang 443003,China)

机构地区：[1]湖北文理学院附属医院[襄阳市中心医院]急诊重症医学科,湖北襄阳441021 [2]三峡大学第一临床医学院[宜昌市中心人民医院]脊柱外科&三峡大学脊柱与创伤研究所,湖北宜昌443003

出　　处：《巴楚医学》2022年第1期60-66,共7页Bachu Medical Journal

基　　金：国家自然科学基金项目(No:31600779);宜昌市医疗卫生研究项目(No:A20-2-007)。

摘　　要：目的:比较Delta内镜下腰椎管减压术(Delta)和显微内窥镜下腰椎管减压术(MED)治疗退行性腰椎管狭窄症(LSS)的临床效果。方法:将有完整随访资料的90例LSS患者根据治疗方式,分为Delta组和MED组,其中Delta组患者41例,MED组患者49例。对两组患者的临床指标进行统计分析。结果:Delta组患者在手术切口长度、术后卧床时间和住院时间上优于MED组。两组患者术后各时间点腿痛VAS及ODI评分较术前均有明显改善(均P<0.05),但术后3月和6月两组患者腿痛VAS评分无统计学差异(均P>0.05)。末次随访时Delta组总体有效率和优良率分别为95.12%和82.93%,MED组总体有效率和优良率分别为93.88%和81.63%,组间差异均无统计学意义(均P>0.05)。结论:Delta和MED术均为腰椎管狭窄症治疗有效的微创术式。与MED比较,Delta内镜创伤更小,术后症状缓解快,短期疗效显著。Objective:To compare the clinical effects of inter laminar endoscopic surgical system Delta(Delta)and microendoscopic discectomy(MED)in the treatment of lumbar spine stenosis(LSS).Methods:There were 90 cases of LSS with complete follow-up data.They were divided into the Delta group and the MED group,including 41 patients in the Delta group and 49 patients in the MED group.The clinical indicators were retrospectively analyzed.Results:Compared to the MED group,incision length,postoperative bed stay and hospital stay were less in the Delta group,all with statistical significance(all P<0.05).VAS and ODI scores of leg pain were significantly improved at each time point after surgery when compared with those before operation in two groups(all P<0.001).But there was no statistical difference in VAS scores between the two groups at 3 and 6 months after surgery(all P>0.05).At the last follow-up,the overall excellent-effective and good rate were 95.12%and 82.93%in the Delta group,while 93.88%and 81.63%in the MED group,respectively,with no statistically significant differences between the groups(both P>0.05).Conclusion:Both Delta and MED are effective minimally invasive procedures for the treatment of LSS,while Delta endoscopy has less trauma,faster postoperative symptom relief,and significant short-term outcomes when compared with MED.

关 键 词：腰椎管狭窄 经皮大通道内镜(Delta)减压术 显微内镜下腰椎间盘切除术 

分 类 号：R826.64[医药卫生—临床医学]