不同MSU分级腰椎间盘突出症患者限制早期下床活动对椎间孔镜手术术后疗效的影响  

The effect of early ambulation restriction on the postoperative outcome of patients with lumbar disc herniation with different MSU grades after percutaneous transforaminal endoscopic discectomy

作　　者：张乐 史小花 胡龙泉 鲁睿 ZHANG Le;SHI Xiaohua;HU Longquan;LU Rui(Department of Interventional Pain,The Second Affiliated Hospital of Air Force Medical University,Xi'an 710038,China;Air Force 94259 Health Corps,Penglai 265600,Shandong,China)

机构地区：[1]空军军医大学第二附属医院介入疼痛科,陕西西安710038 [2]空军94259部队卫生队,山东蓬莱265600

出　　处：《西部医学》2024年第12期1814-1818,共5页Medical Journal of West China

基　　金：国家自然科学基金项目(82172922);空军军医大学第二附属医院国家自然科学基金助推项目(2021ZTXM-002)。

摘　　要：目的探讨不同MSU分级腰椎间盘突出症(LDH)患者经皮椎间孔镜下髓核摘除术(PTED)术后限制早期下地活动对疗效的影响。方法本研究采用回顾性队列研究,选取2018年1月—2020年12月空军军医大学第二附属医院因LDH行PTED治疗的患者162例,将患者分为术后早期下床活动限制组(限制组)和下床活动非限制组(非限制组)。采用视觉模拟量表(VAS)和Oswestry残疾指数(ODI)评分评价术后当天、术后3个月、术后6个月、术后1年的临床疗效。结果术后6个月及术后1年,限制组的腰痛VAS评分低于非限制组,差异具有统计学意义(P<0.05);术后1年,限制组的腿痛VAS评分低于非限制组,两组评分具有统计学差异(P<0.05);术后3个月、术后6个月及术后1年,限制组的ODI评分低于非限制组,差异具有统计学意义(P<0.05);术后1年限制组的疗效优良率明显高于非限制组(P<0.05)。进一步通过MSU分级分层分析,MSU分级为2级时,限制组的疗效优于非限制组(P<0.05)。结论LDH患者PTED术后限制其早期下床活动,尤其是MSU分级为2级的患者,可以减少其术后腰、腿疼,并且改善患者生活功能。Objective To investigate the effect of limiting early ground motion after percutaneous transforaminal endoscopic discectomy(PTED)for lumbar disc herniation(LDH)with different MSU grades.Methods In this study,a retrospective cohort study was used.162 patients who received PTED treatment for LDH from January 2018 to December 2020 were selected.The patients were divided into two groups:early ambulation restriction group and ambulation non-restriction group.Visual analogue scale(VAS)and Oswestry Disability Index(ODI)were used to evaluate the clinical efficacy on the day,3 months,6 months and 1 year after surgery.Results Six months and one year after operation,the VAS score of low back pain in the restricted group was lower than that in the non-restricted group,and there was a statistical difference between the two groups(P<0.05).One year after operation,the VAS score of leg pain in the restricted group was lower than that in the non-restricted group,and there was a statistical difference between the two groups(P<0.05).At 3 months,6 months and 1 year after operation,the ODI score of the restricted group was lower than that of the non-restricted group,and there was a statistical difference between the two groups(P<0.05).One year after operation,the excellent and good rate of the limited group was significantly higher than that of the non-restricted group.Further analysis of MSU grading and stratification showed that when MSU grading was 2,the efficacy of the restricted group was better than that of the non-restricted group.Conclusion Limiting early ambulation of LDH patients after PTED,especially those patients with MSU grade 2,can reduce their postoperative lumbar and leg pain and improve their living function.

关 键 词：腰椎间盘突出症 经皮椎间孔镜下髓核摘除术 MSU分级 限制早期下床活动 

分 类 号：R68[医药卫生—骨科学]