经皮椎间孔镜下髓核摘除术与椎板开窗髓核摘除术治疗腰椎间盘突出症的效果及安全性比较  

Comparison of the Efficacy and Safety of Percutaneous Intervertebral Foraminoscopic Extraction of Nucleus Pulposus and Fenestration of Laminae in the Treatment of Lumbar Disc Herniation

作　　者：彭效硕 PENG Xiaoshuo(Department of Spinal Surgery,Yuncheng Tangta Hospital,Heze 274700,China)

机构地区：[1]郓城唐塔医院脊柱外科,山东菏泽274700

出　　处：《反射疗法与康复医学》2024年第11期162-165,共4页Reflexology And Rehabilitation Medicine

摘　　要：目的对比经皮椎间孔镜下髓核摘除术(PTED)、椎板开窗髓核摘除术(FD)对腰椎间盘突出症(LDH)患者的影响。方法选取2020年5月—2023年5月郓城唐塔医院收治的80例LDH患者为研究对象,按随机数字表法将其分为对照组与观察组,各40例。对照组采用FD治疗,观察组采用PTED治疗,两组术后均持续观察3个月。比较两组的手术情况、疼痛程度、腰椎功能、腰椎活动度、并发症发生情况。结果观察组术中出血量为(31.29±4.27)mL,少于对照组的(58.75±6.65),手术时间为(62.49±6.25)min,下床活动时间为(1.54±0.36)d,住院时间为(6.31±1.26)d,均短于对照组的(83.87±8.96)min、(2.97±0.53)d、(10.46±1.58)d,并发症发生率为5.00%,低于对照组的22.50%,组间差异有统计学意义(P<0.05);术后3个月,观察组的疼痛视觉模拟、Oswestry功能障碍指数评分均低于对照组,腰椎前屈、后伸、右侧屈、左侧屈活动度均大于对照组,组间差异有统计学意义(P<0.05)。结论PTED的损伤更小,并发症更少,有助于LDH患者尽早下床,由此减轻疼痛,加快腰椎功能改善,增大腰椎功能活动度,临床可推广应用。Objective To compare the effect of percutaneous transforaminal endoscopic discectomy(PTED)and fenestration discectomy(FD)on patients with lumbar disc herniation(LDH).Methods A total of 80 LDH patients admitted to Yuncheng Tangta Hospital from May 2020 to May 2023 were selected as the research objects,and were divided into a control group and an observation group according to the random number table method,with 40 cases in each group.The control group was treated with FD,and the observation group was treated with PTED,both groups were observed for 3 months after operation.Compare the surgical conditions,pain levels,lumbar spine function,lumbar spine range of motion,and occurrence of complications between two groups.Results The intraoperative blood loss in the observation group was(31.29±4.27)mL,which was less than(58.75±6.65)mL in the control group,the operative time was(62.49±6.25)min,the time of getting out of bed was(1.54±0.36)d,and the time of hospitalization was(6.31±1.26)d,they were all shorter than(83.87±8.96)min,(2.97±0.53)d and(10.46±1.58)d in the control group,and the complication rate was 5.00%,which was lower than 22.50%in the control group,and the differences between the groups were statistical significance(P<0.05);3 months after operation,the pain Visual Analogue Scale and Oswestry Disability Index scores of the observation group were lower than those of the control group,and the lumbar anterior flexor,posterior extension,right flexor and left flexor motion were higher than those of the control group,and the differences between the groups were statistical significance(P<0.05).Conclusion PTED has less damage and fewer complications,which helps LDH patients get out of bed as soon as possible,thereby reducing pain,accelerating lumbar function improvement,and increasing lumbar functional mobility.It can be widely applied in clinical practice.

关 键 词：腰椎间盘突出症 并发症 腰椎活动度 疼痛 腰椎功能 出血量 

分 类 号：R687.3[医药卫生—骨科学]