经皮椎间孔镜术对腰椎间盘突出症患者炎症反应、疼痛程度和安全性的影响  

The Impact of Percutaneous Transforaminal Endoscopic Surgery on Inflammatory Response,Pain Level,and Safety in Patients with Lumbar Disc Herniation

作　　者：李含[1] 秦晓彬[1] 孙秀钦[1] 翟亚业[1] 张超远[1] 叶向阳[1] LI Han;QIN Xiaobin;SUN Xiuqin;ZHAI Yaye;ZHANG Chaoyuan;YE Xiangyang

机构地区：[1]南阳市中心医院骨科,河南南阳473000

出　　处：《中国医学创新》2024年第35期19-24,共6页Medical Innovation of China

摘　　要：目的:探讨经皮椎间孔镜术对腰椎间盘突出症患者炎症反应、疼痛程度和安全性的影响。方法:回顾性分析2021年2月—2022年3月南阳市中心医院收治的93例腰椎间盘突出症患者的临床资料,根据治疗方式分为观察组(47例)和对照组(46例),对照组给予传统椎板开窗髓核摘除术治疗,观察组给予经皮椎间孔镜术治疗。比较两组患者手术指标(手术时间、切口长度、术中出血量、住院时间),比较两组患者不同时间的炎症反应指标[白细胞介素-21(IL-21)、CXC趋化因子配体10(CXCL10)、白细胞介素-19(IL-19)]水平,比较两组患者不同时间的腰部和下肢疼痛程度[视觉模拟评分法(VAS)评分],比较两组患者不同时间的日本骨科协会评估治疗(JOA)评分、Oswestry功能障碍指数(ODI)评分,以及并发症发生情况。结果:与对照组相比,观察组手术时间长,切口长度和住院时间均短,术中出血量少(P<0.05)。与对照组相比,观察组术后1、3、7 d血清IL-21、CXCL10和IL-19均低(P<0.05);与对照组相比,观察组术后3 d、7 d、1个月和3个月的腰部和下肢VAS评分均低(P<0.05);术后3 d、7 d、1个月、3个月,观察组ODI评分均低于对照组,JOA评分均高于对照组(P<0.05)。观察组并发症发生率为2.13%(1/47),与对照组的10.87%(5/46)比较,差异无统计学意义(P>0.05)。结论:经皮椎间孔镜术治疗腰椎间盘突出症具有创口小、出血量少、恢复快的优点,能有效减轻患者炎症反应,缓解腰腿疼痛,术后并发症较少,安全性高。Objective:To investigate the effects of percutaneous transforaminal endoscopic surgery on inflammatory response,pain level,and safety in patients with lumbar disc herniation.Method:A retrospective analysis was conducted on the clinical data of 93 patients with lumbar disc herniation admitted to Nanyang Central Hospital from February 2021 to March 2022.According to the treatment method,they were divided into an observation group(47 cases)and a control group(46 cases).The control group received traditional laminectomy and nucleus pulposus removal surgery,while the observation group received percutaneous transforaminal endoscopic surgery.The surgical indicators(surgery time,incision length,intraoperative blood loss,hospital stay)were compared between two groups,the levels of inflammatory response indicators[interleukin-21(IL-21),CXC chemokine ligand 10(CXCL10),interleukin-19(IL-19)]were compared between the two groups at different times,the pain degree of lower back and lower limbs[visual analogue scale(VAS)]were compared between the two groups at different times,the Japanese orthopaedic association evaluation treatment(JOA)score and Oswestry disability index(ODI)score at different times and the occurrence of complication of the two groups were compared.Result:Compared with control group,observation group had longer operation time,shorter incision length and hospital stay,and less intraoperative blood loss(P<0.05).Compared with control group,serum IL-21,CXCL10 and IL-19 in observation group were lower at 1,3 and 7 d after surgery(P<0.05).Compared with the control group,the VAS scores in the observation group were lower at 3 d,7 d,1 month and 3 months after surgery(P<0.05).At 3 d,7 d,1 month and 3 months after surgery,ODI scores in observation group were lower than those in control group,JOA scores were higher than those in control group(P<0.05).The incidence of complication in the observation group was 2.13%(1/47),compared with 10.87%(5/46)in the control group,there was no significant difference(P>0.05).Conclusion:P

关 键 词：经皮椎间孔镜术 腰椎间盘突出症 炎症反应 疼痛程度 安全性 

分 类 号：R687.3[医药卫生—骨科学]