经皮椎间孔镜联合围手术期高压氧治疗对腰椎间盘突出症患者的疗效分析  

Analysis of curative effect of percutaneous foraminoscopy combined with perioperative hyperbaric oxygen therapy in patients with lumbar disc herniation

作　　者：蒋传海 吴成如 陈然 孙国荣 史凤之 顾庆陟 JIANG Chuan-hai;WU Cheng-ru;CHEN Ran;SUN Guo-rong;SHI Feng-zhi;GU Qing-zhi(Orthopedics Department of the 901st Hospital of the Joint Logistics Support Force of the People′s Liberation Army of China,Hefei,Anhui 230031,China)

机构地区：[1]中国人民解放军联勤保障部队第901医院骨二科,安徽合肥230031

出　　处：《颈腰痛杂志》2024年第3期503-505,509,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的 探讨经皮椎间孔镜联合围手术期高压氧治疗对腰椎间盘突出症患者的疗效分析。方法 2020年1月~2022年1月,对该科拟行椎间孔镜手术的60例腰椎间盘突出症患者采用随机数字表法进行随机分组:对照组30例,均单纯接受经皮椎间孔镜手术治疗;试验组30例,入院后即开始进行高压氧治疗,围手术期治疗疗程为10 d,每日1次高压氧治疗。测量并记录两组患者术前、术后3 d、术后7 d、术后2周的疼痛视觉模拟评分(visual analogue scale, VAS)和Oswestry功能障碍指数(Oswestry disability index, ODI)。术后2周时,采用改良Macnab标准评估患者是否出现神经根水肿症状。结果 60例患者均顺利完成手术。两组患者术后VAS评分及ODI指数均较术前明显改善(P<0.05);试验组患者术后3 d、术后7 d及术后2周的VAS评分及ODI较对照组明显改善(P<0.05)。试验组患者术后2周改良Macnab标准结果优良率为83.33%,对照组为63.33%,组间差异有统计学意义(P<0.05)。结论 围手术期高压氧治疗,可有效减轻术后残留症状及降低神经根水肿发生率,对腰椎间盘突出症的治疗具有积极作用。Objective To investigate the efficacy of percutaneous endoscopic lumbar discectomy combined with perioperative hyperbaric oxygen therapy in patients with lumbar disc herniation.Methods From January 2020 to January 2022,60 patients with lumbar disc herniation scheduled for percutaneous endoscopic lumbar discectomy in our department were randomly divided into two groups using a random number table:30 patients in the control group underwent percutaneous endoscopic lumbar discectomy alone,while 30 patients in the experimental group began hyperbaric oxygen therapy immediately after hospitalization.The perioperative treatment course was 10 days,with once-daily hyperbaric oxygen therapy.The visual analog scale(VAS)for pain and the Oswestry disability index(ODI)were measured and recorded for both groups of patients before surgery,3 days after surgery,7 days after surgery,and 2 weeks after surgery.At 2 weeks after surgery,the modified Macnab criteria were used to assess whether patients had symptoms of nerve root edema.Results All 60 patients successfully completed the surgery.Both the VAS scores and ODI indices were significantly improved in both groups compared with preoperative levels(P<0.05).The VAS scores and ODI in the experimental group were significantly improved compared with the control group at 3 days,7 days,and 2 weeks after surgery(P<0.05).The excellent and good rate of the modified Macnab criteria was 83.33%in the experimental group and 63.33%in the control group at 2 weeks after surgery,with a statistically significant difference between the groups(P<0.05).Conclusion Perioperative hyperbaric oxygen therapy can effectively reduce postoperative residual symptoms and the incidence of nerve root edema,playing a positive role in the treatment of lumbar disc herniation.

关 键 词：经皮脊柱内镜下腰椎间盘摘除术 腰椎间盘突出症 高压氧治疗 

分 类 号：R681.5[医药卫生—骨科学]