经皮椎间孔镜微创手术治疗腰间盘突出症合并腰椎管狭窄的疗效  

Efficacy of percutaneous transforaminal endoscopic minimally invasive surgery in the treatment of lumbar disc herniation combined with lumbar spinal stenosis

作　　者：王宝 庹银凤 王特哈斯 王树人[2] WANG Bao;TUO Yin-feng;WANG Te-hasi;WANG Shu-ren(Graduate School of Heilongjiang University of Chinese Medicine,Harbin 150006;Department of Bone Injury II,the First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China)

机构地区：[1]黑龙江中医药大学研究生院,黑龙江哈尔滨150006 [2]黑龙江中医药大学附属第一医院骨伤二科,黑龙江哈尔滨150040

出　　处：《川北医学院学报》2024年第8期1056-1058,1063,共4页Journal of North Sichuan Medical College

基　　金：黑龙江省高等学校青年创新人才培养计划(UNPYSCT-2020234)。

摘　　要：目的:探讨经皮椎间孔镜微创手术(PTED)治疗腰间盘突出症(LDH)合并腰椎管狭窄(LSS)的疗效。方法:选取106例LDH合并LSS的患者为研究对象,根据手术方式不同分为微创组和传统组,每组各53例。传统组患者接受传统经椎间孔椎体间融合术治疗;微创组患者接受PTED治疗。比较两组患者手术指标(手术时间、术中出血量、切口长度和住院时间)、疼痛情况[视觉模拟(VAS)评分]、术后腰椎功能恢复[日本骨科协会评估治疗(JOA)评分和Oswestry功能障碍指数(ODI)评分]及并发症发生情况。结果:微创组患者手术时间、术中出血量、切口长度和住院时间均低于传统组(P<0.05);术后1、4、24、48 h的VAS评分均低于传统组(P<0.05)。术后,两组患者JOA评分均升高(P<0.05),且微创组高于传统组(P<0.05);ODI评分均降低(P<0.05),且微创组低于传统组。微创组术后并发症发生率低于传统组(P<0.05)。结论:PTED用于LDH合并LSS患者可以有效减少患者的治疗时间,改善疼痛症状,降低患者术后并发症发生率,还有利于促进患者腰椎功能的恢复,疗效确切且安全性较好。Objective:To investigate the efficacy of percutaneous foraminal minimally invasive surgery(PTED)in the treatment of lumbar disc herniation(LDH)combined with lumbar spinal stenosis(LSS).Methods:A total of 106 patients with LDH combined with LSS were included as the study objects and divided into minimally invasive group and traditional group according to different surgical methods,53 cases in each group.Patients in the traditional group received traditional transforaminal interbody fusion treatment,and patients in the minimally invasive group received PTED treatment.The surgical indicators(surgical time,intraoperative blood loss,incision length,and length of hospital stay),pain status[visual analog scale(VAS)score],postoperative lumbar function recovery[Japanese orthopedic association assessment and treatment(JOA)score,oswestry dysfunction index(ODI)score]and complication rate of the two groups were compared.Results:The operative time,intraoperative blood loss,incision length and hospital stay in minimally invasive group were lower than those in traditional group(P<0.05).Pain scores at 1,4,24 and 48 h in minimally invasive group were lower than those in traditional group(P<0.05).JOA score after surgery was higher in both groups than before surgery,and ODI score was lower than before surgery(P<0.05).Inter-group comparison showed that JOA score after surgery in minimally invasive group was higher than that in traditional group,and ODI score was lower than that in traditional group(P<0.05).The incidence of postoperative complications in minimally invasive group was lower than that in traditional group(P<0.05).Conclusion:PTED can be effectively applied in the treatment of LDH patients with LSS,which can effectively reduce the treatment time of patients,improve pain symptoms,reduce the incidence of postoperative complications,and promote the recovery of lumbar function of patients,with accurate efficacy and good safety.

关 键 词：微创手术 腰间盘突出症 腰椎管狭窄 

分 类 号：R687.3[医药卫生—骨科学]