经皮椎间孔镜下髓核摘除术在不同年龄腰椎间盘突出症人群的疗效分析  

Effect of percutaneous foraminal endoscopic nucleuspulposus extraction on lumbar disc herniation at different ages

作　　者：蒋传海 陈然 孙国荣 史凤之 吴成如 JIANG Chuan-hai;CHEN Ran;SUN Guo-rong;SHI Feng-zhi;WU Cheng-ru(The 901th Hospital of the joint logistics support force of PLA,Hefei,Anhui 230031,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇一医院,安徽合肥230031

出　　处：《颈腰痛杂志》2022年第2期188-191,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨经皮椎间孔镜下髓核摘除术(percutaneous transforaminal endoscopic discectomy,PTED)在不同年龄腰椎间盘突出症(lumbar disc herniation,LDH)人群中的疗效。方法选取2017年2月-2020年6月本院收治的LDH患者65例,按不同年龄分为两组:年龄<45岁者24例,纳入青壮年组;年龄≥45岁者41例,纳入中老年组。两组患者均实施PTED手术治疗,对比分析两组患者的手术指标、并发症发生情况及临床疗效。结果两组手术时间和住院时间差异无统计学意义(P>0.05),青壮年组术后卧床时间显著短于中老年组(P<0.05);青壮年组手术并发症发生率为4.17%,略低于中老年组的7.32%,但组间差异无统计学意义(P>0.05)。与术前相比,两组患者术后3 d~1年时的腰痛、下肢痛VAS评分及ODI指数均获显著改善(P<0.05);组间比较,两组患者术前、术后3 d、3个月时的腰痛、下肢痛VAS评分和ODI指数差异无统计学意义(P>0.05),但青壮年组患者术后6个月、1年时的上述指标均显著低于中老年组,差异有统计学意义(P<0.05)。术后1年时,青壮年组的优良率为91.67%,略高于中老年组的90.24%,但组间差异无统计学意义(P>0.05);青壮年组复发2例(8.33%),中老年组复发4例(9.76%),组间差异无统计学意义(P>0.05)。结论PTED手术治疗不同年龄LDH患者均能获得良好疗效,但青壮年患者术后卧床时间较短,且随着时间的推移,其远期康复效果优于中老年患者。Objective To investigate the efficacy of percutaneous transluminal endoscopic discectomy(PTED)in patients with lumbar disc herniation(LDH)at different ages.Methods 65 patients with LDH treated in our hospital from February 2017 to June 2020 were divided into two groups according to different ages:24 patients younger than 45 years old were included in the young group;41 cases aged≥45 years were included in the middle-aged and elderly group.Both groups were treated with PTED.The surgical indexes,complications and clinical effects of the two groups were compared and analyzed.Results There was no significant difference in operation time and hospital stay between the two groups(P>0.05).The postoperative bed rest time in the young group was significantly shorter than that in the middle-aged and elderly group(P<0.05);The incidence of surgical complications in the young group was 4.17%,slightly lower than 7.32%in the middle-aged and elderly group,but there was no significant difference between the groups(P>0.05).Compared with before operation,the VAS score and ODI index of low back pain and lower limb pain in the two groups were significantly improved 3 days to 1 year after operation(P<0.05);There was no significant difference between the two groups in VAS score and ODI index of low back pain and lower limb pain before operation,3 days and 3 months after operation(P>0.05),but the above indexes at 6 months and 1 year after operation in the young and middle-aged group were significantly lower than those in the middle-aged and elderly group(P<0.05).One year after operation,the excellent and good rate in the young group was 91.67%,which was slightly higher than 90.24%in the middle-aged and elderly group,but there was no significant difference between the groups(P>0.05).There were 2 cases(8.33%)in the young group and 4 cases(9.76%)in the middle-aged and elderly group,there was no significant difference between the two groups(P>0.05).Conclusion PTED surgery can achieve good results in the treatment of LDH patients of differe

关 键 词：腰椎间盘突出症 椎间孔镜 髓核摘除术 青壮年 中老年 

分 类 号：R681.53[医药卫生—骨科学]