PELD及MED治疗不同分型腰椎间盘突出症的效果分析  

Comparison of Therapeutic Effects of PELD and MED on Different Subtypes of Lumbar Disc Herniation

作　　者：李月轩 王晓东[1] 王晓灿 李士学[1] LI Yue-xuan;WANG Xiao-dong;WANG Xiao-can;LI Shi-xue(Department of Spine Surgery,The Fourth People's Hospital of Hengshui,Hengshui,Hebei 053000,China;Department of Imaging Center,The Fourth People's Hospital of Hengshui,Hengshui,Hebei 053000,China)

机构地区：[1]衡水市第四人民医院脊柱外科,河北衡水053000 [2]衡水市第四人民医院影像科,河北衡水053000

出　　处：《河北北方学院学报（自然科学版）》2024年第11期1-4,28,共5页Journal of Hebei North University:Natural Science Edition

摘　　要：目的比较经皮内窥镜下腰椎间盘切除术(percutaneous endoscopic lumbar discectomy,PELD)及显微内窥镜下椎间盘切除术(microendoscopic discectomy,MED)治疗腰椎间盘突出症(lumbar disc herniation,LDH)的临床效果。方法回顾性分析123例单节段LDH患者的临床资料,根据手术方式分为PELD组(69例)与MED组(54例)。比较2组手术前后腰、下肢VAS评分及ODI评分,不同类型LDH术后ODI评分改善情况、手术指标以及术后并发症。结果与术前比较,PELD组与MED组术后ODI与VAS评分均明显下降(P<0.05),但术后组间比较差异无统计学意义(P>0.05)。PELD组极外侧型LDH术后ODI评分改善显著,MED组中央型LDH术后ODI评分改善显著,不同类型LDH术后ODI评分改善情况差异有显著性(P<0.05)。PELD组较MED组手术时间更短、术中出血量更少、住院时间更短(P<0.05)。2组术后并发症差异无显著性(χ^(2)=0.238,P=0.625)。结论PELD与MED对LDH均能取得较好的治疗效果,MED对中央型LDH治疗效果更好,PELD治疗极外侧型LDH效果更佳。Objective To compare the clinical effects of percutaneous endoscopic lumbar discectomy(PELD)and microendoscopic discectomy(MED)in the treatment of lumbar disc herniation(LDH).Methods The clinical data of 123 patients with single segment LDH were retrospectively analyzed.They were divided into PELD group(69 cases)and MED group(54 cases)according to surgical methods.VAS scores and ODI scores of the waist and lower limbs before and after surgery in two groups,the improvement of ODI scores after different types of LDH surgery,surgical indicators,and postoperative complications were compared.Results Compared with preoperative levels,postoperative ODI and VAS scores in PELD group and MED group significantly decreased(P<0.05),but there was no statistically significant difference between the postoperative groups(P>0.05).Postoperative ODI score of extreme lateral type LDH in PELD group improved significantly,while postoperative ODI score of central type LDH in MED group improved significantly.There were significant differences in the improvement of postoperative ODI score among different types of LDH(P<0.05).PELD group had shorter surgical time,less intraoperative bleeding,and shorter hospital stay compared with MED group(P<0.05).There was no significant difference in postoperative complications between the two groups(χ^(2)=0.238,P=0.625).Conclusion Both PELD and MED can achieve good therapeutic effects on LDH,with MED having better therapeutic effects on central type LDH and PELD having better therapeutic effects on extremely lateral type LDH.

关 键 词：腰椎间盘突出症 经皮内窥镜下腰椎间盘切除术 显微内窥镜下椎间盘切除术 

分 类 号：R687.3[医药卫生—骨科学]