探讨经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症的效果  

Effect of Percutaneous Intervertebral Foraminoscopic Extraction of Nucleus Pulposus for Lumbar Disc Herniation

作　　者：曾四宝[1] 高增鑫[1] 程庆华 陆海涛 ZENG Sibao;GAO Zengxin;CHENG Qinghua;LU Haitao(Department of Orthopedics,Nanjing Lishui District People´s Hospital(Lishui Branch of Large Hospital Affiliated to Southeast University),Nanjing,Jiangsu Province,211200 China)

机构地区：[1]南京市溧水区人民医院(东南大学附属中大医院溧水分院)骨科,江苏南京211200

出　　处：《世界复合医学》2022年第12期165-168,共4页World Journal of Complex Medicine

基　　金：2021年度南京市卫生科技发展专项资金项目(YKK21205)。

摘　　要：目的 探讨经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症的效果。方法 回顾性分析2018年4月—2021年11月南京市溧水区人民医院收治的81例腰椎间盘突出症患者的临床资料,根据治疗方法分为对照组(35例,传统保守方法治疗)和观察组(46例,经皮椎间孔镜下髓核摘除术治疗),比较两组住院时间、疼痛度、腰部活动功能与并发症发生率。结果 观察组住院时间(6.20±1.20)d短于对照组,差异有统计学意义(t=15.177,P<0.05);观察组治疗3个月后的VAS评分(1.82±0.46)分和ODI(20.77±3.28)分低于对照组,差异有统计学意义(t=3.939、6.006,P<0.05);观察组治疗3个月后的腰椎前屈(82.12±8.46)o、后伸(22.10±5.45)o、左侧屈(22.46±4.81)o与右侧屈角度(22.63±4.88)o均大于对照组,差异有统计学意义(t=3.073、2.385、3.626、3.736,P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论 经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症可减轻患者机体疼痛度,加快腰椎功能恢复,减少并发症的发生。Objective To investigate the effect of percutaneous intervertebral foraminoscopic excision of nucleus pulposus for lumbar disc herniation.Methods The clinical data of 81 patients with lumbar disc herniation admitted to Nanjing Lishui District People´s Hospital from April 2018 to November 2021 were retrospectively analyzed.According to the treatment method,they were divided into control group(35 cases,conventional conservative treatment)and observation group(46 patients,treated by percutaneous interforaminal microscopic nucleus pulpotomy).Length of stay,pain degree,lumbar mobility and complication rate were compared between the two groups.Results The length of hospitalization in the observation group(6.20±1.20)d was shorter than that in the control group,the difference was statistically significant(t=15.177,P<0.05).The VAS score(1.82±0.46)points and ODI(20.77±3.28)points of the observation group were lower than those of the control group after 3 months of treatment,the difference was statistically significant(t=3.939,6.006,P<0.05).After 3 months of treatment,the lumbar flexion(82.12±8.46)o,extension(22.10±5.45)o,left flexion(22.46±4.81)o and right flexion angles(22.63±4.88)o in the observation group were all greater than those in the control groupt,the difference was statistically significant(t=3.073,2.385,3.626,3.736,P<0.05).The complication rate in the observation group was lower than that in the control group, the difference was statistically significant (P<0.05). Conclusion Thetreatment of lumbar disc herniation by percutaneous intervertebral foraminoscopy can reduce the pain, accelerate the recovery of lumbar functionand reduce the incidence of complications.

关 键 词：腰椎间盘突出症 保守治疗 髓核摘除术 疼痛 腰椎功能 并发症 

分 类 号：R681[医药卫生—骨科学]