单侧双通道脊椎内镜与经皮内镜下髓核切除术治疗腰椎间盘突出症的效果对比  

Comparison of the Effect of Unilateral Dual-channel Spinal Endoscopy and Percutaneous Endoscopic Nucleus Pulposus Resection in the Treatment of Lumbar Disc Herniation

作　　者：胡应东 王伟 兰魁勇 HU Yingdong;WANG Wei;LAN Kuiyong(Department of Orthopedic Spine and Trauma Ward,China Railway Fuyang Hospital,Fuyang 236000,China;不详)

机构地区：[1]中铁阜阳医院骨科脊柱与创伤病区,安徽阜阳236000

出　　处：《中国医学创新》2024年第36期38-42,共5页Medical Innovation of China

摘　　要：目的:探讨单侧双通道脊椎内镜与经皮内镜下髓核切除术治疗腰椎间盘突出症的效果对比。方法:回顾性分析2022年1月—2023年12月中铁阜阳医院收治的96例腰椎间盘突出症患者的临床资料,按照手术方式分为观察组(单侧双通道脊椎内镜下髓核切除术治疗,n=48)和对照组(经皮内镜下髓核切除术治疗,n=48)。比较两组术后疼痛情况、功能恢复情况、手术指标及并发症发生情况。结果:术后12、24 h,两组视觉模拟评分法(VAS)评分均低于术前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。术后,两组Oswestry功能障碍指数(ODI)评分比较,差异无统计学意义(P>0.05)。对照组切口长度短于观察组,术中X线照射次数多于观察组,术中出血量少于观察组,差异均有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:经皮内镜下髓核切除术和单侧双通道脊椎内镜下髓核切除术治疗腰椎间盘突出症均可获得相对满意的临床效果,单侧双通道脊椎内镜技术产生的术中X线照射次数较少,而经皮内镜下髓核切除术的切口长度较短、术中出血量较少;临床可根据患者具体情况选择适宜的内镜方式。Objective:To investigate the effect of unilateral dual-channel spinal endoscopy and percutaneous endoscopy nucleus pulposus resection in the treatment of lumbar disc herniation.Method:The clinical data of 96 patients with lumbar disc herniation admitted to China Railway Fuyang Hospital from January 2022 to December 2023 were retrospectively analyzed.According to the surgical method,they were divided into observation group(unilateral dual-channel spinal endoscopy nucleus pulposus resection,n=48)and control group(percutaneous endoscopy nucleus pulposus resection,n=48).The postoperative pain,functional recovery,operative indexes and complications between the two groups were compared.Result:At 12 and 24 h after surgery,visual analogue scale (VAS) scores of the two groups were lower than those before operation, and those in observation group were lower than those in control group, the differences were statistically significant (P<0.05). After surgery, there was no significant difference in Oswestry disability index (ODI) score between the two groups (P>0.05). The incision length of control group was shorter than that of observation group, the number of intraoperative X-ray irradiation was more than that of observation group, and the amount of intraoperative bleeding was less than that of observation group, the differences were statistically significant (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion: In the treatment of lumbar disc herniation, both percutaneous endoscopy nucleus pulposus resection and unilateral dual-channel spinal endoscopy nucleus pulposus resection can achieve relatively satisfactory clinical results. Unilateral dual-channel spinal endoscopy produces fewer intraoperative X-ray exposures, while percutaneous endoscopy nucleus pulposus resection has shorter incision length and less intraoperative blood loss. The appropriate endoscopic method can be selected according to the specific conditions of patients.

关 键 词：单侧双通道脊椎内镜 经皮内镜下髓核切除术 腰椎间盘突出 腰椎间盘手术 

分 类 号：R687.3[医药卫生—骨科学]