经皮椎间孔镜技术治疗腰椎间盘突出症的疗效  

The effect of percutaneous transforaminal endoscopic discectomy in the treatment of lumbar disc herniation

作　　者：何胤[1] 李志琳 贾涛[1] 任大伟[1] 席天平 HE Yin;LI Zhi-lin;JIA Tao;REN Da-wei;XI Tian-ping(Dept of Orthopaedics,the Central Hospital of Guangyuan City,Guangyuan,Sichuan 628000,China)

机构地区：[1]广元市中心医院骨科,四川广元628000

出　　处：《临床骨科杂志》2024年第6期780-784,共5页Journal of Clinical Orthopaedics

基　　金：四川省广元市科技局重点研发项目(编号:19ZDYF0092)。

摘　　要：目的探讨经皮椎间孔镜技术治疗腰椎间盘突出症的疗效。方法将72例腰椎间盘突出症患者按手术方式不同分为对照组(采用椎板开窗髓核摘除术治疗,32例)和观察组(采用经皮椎间孔镜技术治疗,40例)。记录术中出血量、切口长度、术后下地时间、住院时间,采用VAS评分评估腰、腿疼痛程度,采用RMDQ评分评估运动功能,采用ODI评分评价腰椎功能。结果患者均获得随访,时间12~18个月。术中出血量、切口长度、术后下地时间、住院时间观察组均小(短)于对照组(P<0.01)。两组术后第1天及1、12个月腰痛和腿痛VAS评分均低于术前(P<0.05);术后第1天腰痛VAS评分观察组低于对照组(P<0.01),腿痛VAS评分两组比较差异无统计学意义(P>0.05);术后1、12个月腰痛和腿痛VAS评分两组比较差异均无统计学意义(P>0.05)。术后12个月ODI评分、RMDQ评分两组均低于术前(P<0.05),两组比较差异均无统计学意义(P>0.05)。结论经皮椎间孔镜技术可有效治疗腰椎间盘突出症,术中创伤小,术后患者恢复快。Objective To investigate the effect of percutaneous transforaminal endoscopic discectomy(PTED)in the treatment of lumbar disc herniation.Methods The 72 patients with lumbar disc herniation were divided into control group(32 cases were treated by laminae fenestration and discectomy)and observation group(40 cases were treated by PTED).Intraoperative blood loss volume,incision length,postoperative time of standing on the ground,and hospital stay were recorded.VAS was used to evaluate the degree of lumbar and leg pain,RMDQ score was used to evaluate motor function,and ODI score was used to evaluate lumbar function.Results All patients were followed up for 12~18 months.The volume of intraoperative blood loss,incision length,postoperative time of standing on the ground,and hospital stay in the observation group were smaller(shorter)than those in the control group(P<0.01).At 1 d and 1,12 months after surgery,the VAS of lumbago and leg pain were lower than those before surgery(P<0.05).At 1 d after surgery,the VAS of lumbago pain in the observation group was lower than that of the control group(P<0.01),and there was no statistical difference in the VAS of leg pain(P>0.05).At 1,12 months after surgery,there were no statistical differences in VAS for lumbago and leg pain between the two groups(P>0.05).At 12 months after surgery,ODI scores and RMDQ scores were lower than those before surgery(P<0.05),and there were no statistical significance between the two groups(P>0.05).Conclusions PTED is effective in the treatment of lumbar disc herniation,with less intraoperative trauma and faster postoperative recovery.

关 键 词：腰椎间盘突出症 经皮椎间孔镜技术 

分 类 号：R681.57[医药卫生—骨科学] R687.3[医药卫生—外科学]