比较椎板开窗髓核摘除术与经皮椎间孔脊柱内镜术在腰椎间盘突出症高龄患者中的实施效果  

To Compare the Effect of Laminectomy and Percutaneous Foraminal Spinal Endoscopy in Elderly Patients with Lumbar Disc Herniation

作　　者：艾国庆 AI Guoqing(Department of orthopedics,Fuxin second Peoples hospital(Fuxin obstetrics and gynecology hospital),Fuxin,Liaoning province 123000)

机构地区：[1]辽宁省阜新市第二人民医院一阜新市妇产医院骨二科,辽宁阜新123000

出　　处：《中国伤残医学》2023年第14期10-14,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:以腰椎间盘突出症高龄患者为对象,探究对比经皮椎间孔脊柱内镜术和椎板开窗髓核摘除术治疗的效果。方法:选取我院2019年3月一2021年3月接收的90例腰椎间盘突出症高龄患者为对象,以数字号形式随机分设研究所选病例,即对照组(n=45)、观察组(n=45)。对照组患者行椎板开窗髓核摘除术治疗,观察组患者行经皮椎间孔脊柱内镜术治疗。以术中、术后指标,VAS评分、腰椎功能评分、腰背肌生物力学性能、脊柱对称性、TIMPs和MMPs表达为判定指标,对不同手术治疗取得效果分析。结果:在比较术中、术后指标中,较对照组,观察组术中出血量更少,手术时间、卧床时间和住院时间更短(P<0.05);在比较VAS评分、腰椎功能评分中,术后,较对照组,观察组VAS评分更低,腰椎功能评分更高(P<0.05);治疗后,对照组的PT、AP分值变化低于观察组,F/E分值变化高于观察组,差异有统计学意义(P<0.05);治疗后,对照组脊柱对称性的数据结果变化均高于观察组,差异有统计学意义(P<0.05);治疗后,对照组TIMPs、MMPs表达的数据结果变化均高于观察组,差异有统计学意义(P<0.05)。结论:相比锥板开窗髓核摘除术,对腰椎间盘突出症高龄患者行经皮椎间孔脊柱内镜术治疗,效果佳,能有效减少患者术中出血量,降低术后疼痛感,加快腰椎功能恢复,改善患者脊柱对称性、腰背肌生物力学性能和TIMPs与MMPs表达,住院时间缩短。Objective:To investigate and compare the effect of percutaneous foraminal endoscopic surgery and laminectomy for nucle-us pulposus removal in elderly patients with lumbar disc herniation.Methods:90 elderly patients with lumbar disc herniation received by our hospital from March 2019 to March 2021 were selected as subjects,and the selected cases were randomly divided into control group(n=45)and observation group(n=45)in the form of numbers.The patients in the control group were treated with laminectomy and the patients in the observation group were treated with percutaneous foraminal spinal endoscopy.The results of different surgical treatments were analyzed by using intraoperative and postoperative indicators,VAS score,lumbar function score,biomechanical properties of lumbar dorsal muscles,spinal symmetry,TIMPs and MMPs expression as judgment indicators.Results:In the comparison of intraoperative and postoperative indicators,compared with the control group,the observation group had less intraoperative bleeding,shorter operation time,bed rest time and hospital stay(P<0.05).In the comparison of VAS score and lumbar function score,compared with the control group,the VAS score in the observation group was lower and the lumbar function score was higher(P<0.05).After treatment,the PT and AP scores in the control group were lower than those in the observation group,while the F/E scores were higher than those in the observation group,with a statistically significant difference(P<0.05).Affer treatment,the changes of spinal symmetry data in the control group were significantly higher than those in the observation group(P<0.05).After treatment,the data of TIMPs and MMPs expression in the control group were significantly higher than those in the observation group(P<0.05).Conclusion:Compared with cone plate fenestra-tion nucleus pulposus extraction,percutaneous foraminal spinal endoscopy is effective for the treatment of elderly patients with lumbar disc herniation.It can effectively reduce the amount of intraoperative bleedi

关 键 词：腰椎间盘突出症 经皮椎间孔脊柱内镜术 锥板开窗髓核摘除术 

分 类 号：R681.5[医药卫生—骨科学]