不同手术方法在缓解腰椎间盘突出症患者疼痛及改善腰椎功能中的应用对比  

Comparison of application effects of different surgical methods in relieving pain and improving lumbar function in patients with lumbar disc herniation

作　　者：蒲晓杰 刘亚 申圳 PU Xiao-jie;LIU Ya;SHEN Zhen(Department of Anesthesiology,Zhengzhou Ninth People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市第九人民医院麻醉科,郑州450000

出　　处：《医药论坛杂志》2022年第5期36-39,共4页Journal of Medical Forum

摘　　要：目的探讨显微内窥镜下椎间盘切除术(MED)和经皮内窥镜下腰椎椎间盘切除术(PELD)在缓解腰椎椎间盘突出症(LDH)患者疼痛及改善腰椎功能中的应用效果。方法选取郑州市第九人民医院2019年1月至2020年12月期间113例腰椎椎间盘突出症患者作为研究对象,分为MED组和PELD组两组,MED组56例给予显微内窥镜下椎间盘切除术,PELD组57例给予经皮内窥镜下腰椎椎间盘切除术,对比两组患者围术期指标,疼痛程度、腰椎功能、并发症发生情况。结果术前,两组患者的疼痛程度评分、腰椎功能评分等比较均无统计学意义(P>0.05);术后,PELD组的切口长度、手术时间、术后卧床时间、术后住院时间少于MED组,术中透视次数多于MED组(P<0.05);术后,两组的Oswestry功能障碍指数(ODI)、日本骨科学会(JOA)评分,腰痛、腿痛视觉模拟疼痛(VAS)评分均较术前发生变化(P<0.05),但两组间比较无统计学意义(P>0.05);两组患者的并发症发生情况比较无统计学意义(P>0.05)。结论MED和PELD均能有效治疗LDH患者,但PELD更微创,可以促进患者快速康复,而MED可以减少术中透视次数,降低放射线辐射,临床可根据患者自身情况进行手术选择。Objective To explore the application of microendoscopic discectomy(MED)and percutaneous endoscopic lumbar discectomy(PELD)in relieving pain and improving lumbar spine function in patients with lumbar disc herniation(LDH)effect.Methods Totally 113 patients with lumbar disc herniation in our department from January 2019 to December 2020 were selected as the research objects,and they were divided into two groups by lottery.56 patients in the MED group were given microendoscopic discectomy 57 cases in the PELD group were treated with percutaneous endoscopic lumbar discectomy.The perioperative indexes,pain degree,lumbar function,and complications of the two groups were compared.Results Before operation,there was no statistically significant comparison between the two groups of patients’pain scores and lumbar spine function scores(P>0.05);Postoperatively,the length of incision,operation time,postoperative time in bed,and postoperative hospital stay in the PELD group Less than the MED group,the number of intraoperative fluoroscopy was more than that of the MED group(P<0.05);After the operation,the Oswestry dysfunction index(ODI),the Japanese Orthopaedic Association(JOA)score,low back pain,leg pain,visual analog pain(VAS)were changed compared with those before operation(P<0.05),but there was no statistical significance between the two groups(P>0.05);The complications of the two groups were not statistically significant(P>0.05).Conclusion Both MED and PELD can effectively treat LDH patients,but PELD is more minimally invasive and can promote rapid recovery of patients,while MED can reduce the number of intraoperative fluoroscopy and reduce radiation radiation.Clinical surgery can be selected according to the patient’s own situation.

关 键 词：显微内窥镜下椎间盘切除术 经皮内窥镜下腰椎椎间盘切除术 腰椎椎间盘突出症 腰椎功能 

分 类 号：R681.5[医药卫生—骨科学]