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 Endoscopic Lumbar Discectomy in the Treatment of Lumbar Disc Herniation

作　　者：谢瑞堂 莫似环 黄冲 覃琼瑶 刁百新 黄延望 XIE Ruitang;MO Sihuan;HUANG Chong;QIN Qiongyao;DIAO Baixin;HUANG Yanwang(Gangbei District People's Hospital,Guigang,Guangxi,Guigang 537100,China;不详)

机构地区：[1]广西贵港市港北区人民医院,广西贵港537100

出　　处：《中国医学创新》2023年第29期20-24,共5页Medical Innovation of China

摘　　要：目的:分析经皮椎间孔镜下髓核摘除术(PELD)治疗腰椎间盘突出症的效果。方法:选取2020年1月—2022年1月在贵港市港北区人民医院收治的腰椎间盘突出症患者80例,采用随机数字表法分为A组和B组,各40例。A组采用传统开窗椎板减压术,B组采用PELD。比较两组术后3个月总有效率,术前、术后1周和术后1、3、6个月的腰椎日本骨科协会评估治疗(JOA)评分、视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)评分。结果:术后3个月,B组总有效率为92.50%,显著高于A组的75.00%(χ^(2)=4.50,P=0.034);术后6个月内,A组仅有1例18岁的女性患者于术后4个月复发,B组无复发病例,两组复发情况比较,差异无统计学意义(P>0.05);B组术后1周和术后1、3、6个月的ODI、VAS评分均显著低于A组(P<0.05),术后6个月,B组的腰椎JOA评分显著高于A组(P<0.05)。结论:PELD对腰椎间盘突出患者具有较好的治疗效果,患者的疼痛症状、腰椎功能都能较好改善,手术时间相对较短,临床应用具有一定优势。Objective:To analyze the effect of percutaneous endoscopic lumbar discectomy in the treatment of lumbar disc herniation.Method:A total of 80 patients with lumbar disc herniation admitted to Gangbei District People's Hospital,Guigang from January 2020 to January 2022 were selected,group A and group B were divided by random number table method,with 40 cases each.The group A was treated with traditional decompression via vertebral lamina fenestration,while the group B was treated with percutaneous endoscopic lumbar discectomy.The total response rate at 3 months after surgery was compared between the two groups,the lumbar spine Japanese orthopaedic association evaluation treatment(JOA)score,visual analogue scale(VAS)score and Oswestry disability index(ODI)score were compared between the two groups before surgery,1 week after surgery and 1 month and 3,6 months after surgery.Result:3 months after surgery,the total effective rate of group B was 92.50%,which was significantly higher than 75.00% of group A(χ^(2)=4.50,P=0.034).Within 6 months after surgery,only one 18-yearold female patient in group A relapsed 4 months after surgery,while no recurrence occurred in group B,there was no statistically significant difference in recurrence between the two groups(P>0.05).ODI and VAS scores of group B at 1 week,1 month and 3,6 months after surgery were significantly lower than those of group A(P<0.05),6 months after surgery,the lumbar JOA score in group B was significantly higher than that in group A(P<0.05).Conclusion:PELD has a good therapeutic effect on patients with lumbar disc herniation,and the pain symptoms and lumbar function of patients can be improved better,the operation time is relatively short,and the clinical application has certain advantages.

关 键 词：腰椎间盘突出症 经皮椎间孔镜下髓核摘除术 开窗椎板减压术 

分 类 号：R687.3[医药卫生—骨科学]