椎间孔镜下神经根减压松解术联合综合康复训练治疗腰椎间盘突出症疗效观察  

Clinical effect of broad easy immediate surgery combined with comprehensive rehabilitation training in the treatment of lumbar disc herniation

作　　者：张天吉[1] 马丽[2] ZHANG Tianji;MA Li(Department of Orthopedics,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China;Nursing Department,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China)

机构地区：[1]新乡医学院第三附属医院骨科,河南新乡453003 [2]新乡医学院第三附属医院护理部,河南新乡453003

出　　处：《新乡医学院学报》2023年第3期219-223,共5页Journal of Xinxiang Medical University

基　　金：河南省医学科技攻关计划联合共建项目(编号:2018020380)。

摘　　要：目的探讨椎间孔镜下神经根减压松解术(BEIS)联合综合康复训练治疗腰椎间盘突出症的近期(术后3、6个月)和远期(术后12个月)临床疗效。方法选择2018年5月至2020年5月新乡医学院第三附属医院收治的78例腰椎间盘突出症患者为研究对象,根据治疗方法将患者分为对照组(n=38)和康复训练组(n=40)。2组患者均给予BEIS治疗,康复训练组患者于术后第2天开始进行3个月的综合康复训练,对照组患者未进行综合康复训练。术前及术后3、6、12个月时,采用日本骨科协会评估治疗分数(JOA)评估2组患者的神经功能,采用视觉模拟评分法(VAS)评估患者腰部疼痛程度,采用生活质量量表评估患者的生活质量。术后3、6、12个月时,根据NaKai疗效评估标准评估2组患者的临床疗效,并计算优良率。结果2组患者术前JOA、VAS、生活质量量表各维度评分比较差异无统计学意义(P>0.05)。2组患者术后3、6、12个月时的JOA评分、生活质量量表各维度评分均显著高于术前,VAS评分显著低于术前(P<0.05);术后3、6个月,康复训练组患者JOA评分、生活质量量表各维度评分均显著高于对照组,VAS评分显著低于对照组(P<0.05);术后12个月,2组患者的JOA、VAS评分及生活质量量表各维度评分比较差异无统计学意义(P>0.05)。术后3、6、12个月,康复训练组患者的优良率分别为62.5%(25/40)、77.5%(31/40)、82.5%(33/40),对照组患者的优良率分别为47.37%(18/38)、55.26%(21/38)、76.32%(29/38)。康复训练组患者术后3、6个月时的优良率显著高于对照组(χ^(2)=4.724、6.321,P<0.05);2组患者术后12个月时的优良率比较差异无统计学意义(χ^(2)=2.458,P>0.05)。结论BEIS联合综合康复训练治疗腰椎间盘突出症患者的近期疗效优于未进行综合康复训练者,远期疗效无明显差异。Objective To explore the short-term(3,6 months after operation)and long-term(12 months after operation)curative effect of broad easy immediate surgery(BEIS)combined with comprehensive rehabilitation training in the treatment of lumbar disc herniation.Methods A total of 78 patients with lumbar disc herniation admitted to the Third Affiliated Hospital of Xinxiang Medical University from May 2018 to May 2020 were selected as the research objects.The patients were divided into control group(n=38)and rehabilitation training group(n=40)according to the treatment methods.All patients were treated with BEIS.The patients in the rehabilitation training group received 3 months of comprehensive rehabilitation training from the second day after operation,while the patients in the control group did not receive comprehensive rehabilitation training.Before operation and at 3,6 and 12 months after operation,the neurological function of patients in the two groups was evaluated by Japanese Orthopaedic Association Scores(JOA),the pain degree of lumbar of patients in the two groups was evaluated by visual analogue scale(VAS),the quality of life of patients in the two groups was evaluated by the quality of life scale.At 3,6 and 12 months after operation,the clinical efficacy of patients in the two groups was evaluated according to the NaKai efficacy evaluation standard,and the fineness rate was calculated.Results There was no significant difference in the JOA,VAS scores and the scores of each dimension of quality of life scale of patients between the two groups before operation(P>0.05).The scores of JOA and each dimension of quality of life scale of patients in the two groups at 3,6 and 12 months after operation were significantly higher than those before operation(P<0.05),the VAS score was significantly lower than that before operation(P<0.05).At 3,6 months after operation,the scores of JOA and each dimension of quality of life scale of patients in the rehabilitation training group were significantly higher than those in the control

关 键 词：腰椎间盘突出症 椎间孔镜下神经根减压松解术 综合康复训练 

分 类 号：R68[医药卫生—骨科学]