经皮椎间孔镜下腰椎间盘切除术与小切口椎板间开窗髓核摘除术治疗腰椎间盘突出症患者的效果比较  

Comparison of effects of percutaneous endoscopic lumbar discectomy and small incision fenestration discectomy in treatment of patients with lumbar disc herniation

作　　者：张朋 周献伟 李帅垒 ZHANG Peng;ZHOU Xianwei;LI Shuaieird(Department of Orthopaedics of Tongxu County Hospital of Traditional Chinese Medicine,Kaifeng 475400 Henan,China;Department of Orthopaedics of Henan Orthopaedic Hospital,Zhengzhou 475000,China)

机构地区：[1]通许县中医院骨三科,河南开封475400 [2]河南省骨科医院骨科,河南郑州475000

出　　处：《中国民康医学》2024年第16期135-137,141,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较经皮椎间孔镜下腰椎间盘切除术(PEID)与小切口椎板间开窗髓核摘除术治疗腰椎间盘突出症(LDH)患者的效果。方法:选取2020年1月至2023年1月通许县中医院收治的82例LDH患者进行前瞻性研究,按随机数字表法将其分为对照组(n=41)与研究组(n=41)。对照组采用小切口椎间板开窗髓核摘除术治疗,研究组采用PEID治疗。比较两组手术相关指标水平、临床疗效,手术前后创伤应激指标[肾上腺素(E)、皮质醇(Cor)]水平、腰椎功能[日本骨科协会评估治疗(JOA)]评分,以及并发症发生率。结果:研究组术中出血量少于对照组,手术时间、切口长度、术后卧床时间均短于对照组,差异有统计学意义(P<0.05);两组治疗总有效率比较,差异无统计学意义(P>0.05);术后24 h,两组E、Cor水平均高于术前,但研究组低于对照组,差异有统计学意义(P<0.05);术后3个月,两组JOA评分均高于术前,且研究组高于对照组,差异有统计学意义(P<0.05);研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:PEID治疗LDH患者可提高腰椎功能,降低手术相关指标水平和并发症发生率,其效果优于小切口椎间板开窗髓核摘除术治疗。Objective:To compare effects of percutaneous endoscopic lumbar discectomy(PEID)and small incision fenestration discectomy in treatment of patients with lumbar disc herniation(LDH).Methods:A prospective study was conducted on 82 patients with LDH admitted to Tongxu county hospital of traditional Chinese medicine from January 2020 to January 2023.According to the random number table method,they were divided into control group(n=41)and study group(n=41).The control group was treated with small incision fenestration discectomy,while the study group was treated with PEID.The levels of surgical-related indexes,the clinical efficacy,the levels of traumatic stress indexes[epinephrine(E)and cortisol(Cor)],the lumbar function[Japanese Orthopaedic Association(JOA)score],and the incidence of complications were compared between the two groups before and after the surgery.Results:The intraoperative blood loss in the study group was less than that in the control group;the operation time,the incision length and the postoperative bed rest time were shorter than those in the control group;and the differences were statistically significant(P<0.05).At 24 h after the surgery,the levels of E and Cor in the two groups were higher than those before operation,but those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).At 3 months after the surgery,the JOA scores of the two groups were higher than those before the surgery,that in the study group was higher than that in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusions:PEID in the treatment of the LDH patients can improve the lumbar function and reduce the levels of surgery-related indexes and the incidence of complications.Moreover,it is superior to small incision fenestration discectomy.

关 键 词：经皮椎间孔镜下腰椎间盘切除术 小切口椎板间开窗髓核摘除术 腰椎间盘突出症 腰椎功能 创伤应激指标 并发症 

分 类 号：R681.5[医药卫生—骨科学]