经皮椎间孔镜术与传统开窗术治疗腰椎间盘突出症临床疗效比较  

Comparison of Clinical Effect between Percutaneous Foraminoscopy and Traditional Fenestration in the Treatment of Lumbar Disc Herniation

作　　者：凡军 沙勇 纪亲龙 王少峰 夏春欢 Fan Jun;Sha Yong;Ji Qinlong;Wang Shaofeng;Xia Chunhuan(Department of Orthopedics,Tinglin Hospital of Jinshan District,Shanghai,201505,China)

机构地区：[1]上海市金山区亭林医院骨科,上海201505

出　　处：《中国初级卫生保健》2024年第4期107-110,共4页Chinese Primary Health Care

摘　　要：目的:比较经皮椎间孔镜术与传统开窗术治疗腰椎间盘突出症的临床疗效。方法:选取2020年3月—2022年6月在上海市金山区亭林医院骨科就诊的98例腰椎间盘突出症患者,采用随机数字表法将其分为对照组(n=49)和观察组(n=49)。对照组采用传统开窗手术,观察组采用经皮椎间孔镜手术。结果:观察组患者出血量、手术时间及住院时间均少于对照组,差异有统计学意义(t值分别为44.387、15.639和11.514,P值均<0.05)。手术后3 d,两组患者血红蛋白及血钙水平均较手术前下降,但观察组患者血红蛋白及血钙水平下降幅度低于对照组,差异有统计学意义(t值分别为13.246、69.296,P值均<0.05)。两组患者视觉模拟评分法(Visual Analogue Scale,VAS)评分和Oswestry功能障碍指数(Oswestry Disability Index,ODI)评分均随术后时间延长而逐渐降低,且观察组治疗后1个月、治疗后3个月的VAS评分和ODI评分均低于对照组。观察组治疗有效率为93.88%,高于对照组(79.59%),差异有统计学意义(χ_(2)=4.346,P<0.05)。观察组术后并发症发生率为4.08%,低于对照组(16.33%),差异有统计学意义(χ_(2)=4.009,P<0.05)。结论:经皮椎间孔镜术相较于传统开窗手术治疗腰椎间盘突出,患者治疗效果更好。OBJECTIVE To compare the clinical effect of percutaneous foraminoscopy and traditional fenestration in the treatment of lumbar disc herniation.METHODS 98 patients with lumbar disc herniation admitted to the Department of Orthopedics,Tinglin Hospital,Jinshan District,Shanghai from March 2020 to June 2022 were selected and divided into control group(n=49)and observation group(n=49)by random number table method.The control group underwent traditional fenestration surgery,and the observation group underwent percutaneous transforaminal surgery.RESULTS The amount of blood loss,operation time and hospital stay in the observation group were lower than those in the control group,and the differences were statistically significant(t=44.387,15.639,11.514,P<0.05).At 3 days after operation,hemoglobin and blood calcium levels in both groups decreased compared with those before operation,but the decrease rate of hemoglobin and blood calcium levels in the observation group was lower than that in the control group,with statistical significance(t=13.246,69.296,P<0.05).Visual analogue scale(VAS)scores and Oswestry Disability Index(ODI)scores of patients in both groups decreased gradually with the extension of postoperative time,and the VAS scores and ODI scores of the observation group at 1 month and 3 months after treatment were lower than those of the control group.The effective rate of observation group was 93.88%,which was higher than that of control group(79.59%),and the difference was statistically significant(χ_(2)=4.346,P<0.05).The incidence of postoperative complications in the observation group was4.08%,lower than that in the control group(16.33%),and the difference was statistically significant(χ_(2)=4.009,P<0.05).CONCLUSION Percutaneous foraminoscopy is more effective than traditional fenestration in the treatment of lumbar disc herniation.

关 键 词：经皮椎间孔镜术 传统开窗术 腰椎间盘突出症 临床疗效 

分 类 号：R687.3[医药卫生—骨科学]