UBE、TESSYS治疗伴中心型肥胖的腰椎管狭窄症的临床疗效观察  

The clinical efficacy of UBE and TESSYS on lumbar spinal stenosis with central obesity

作　　者：罗潇 雷超 何依靓 段先毓 范斌[1] LUO Xiao;LEI Chao;HE Yiliang;DUAN Xianyu;FAN Bin(Department of Spinal Surgery and Pain,Mianyang Third People's Hospital/Sichuan Mental Health Center,Mianyang 621000;Department of Medical Records,Mianyang Central Hospital,Mianyang 621000;Department of Radiology,Mianyang Hospital of Traditional Chinese Medicine,Mianyang 621000)

机构地区：[1]绵阳市第三人民医院/四川精神卫生中心脊柱外科/疼痛科,绵阳621000 [2]绵阳市中心医院病案室,绵阳621000 [3]绵阳市中医院放射科,绵阳621000

出　　处：《湖南师范大学学报(医学版)》2024年第5期116-122,共7页Journal of Hunan Normal University(Medical Sciences)

基　　金：2020年四川省医学(青年创新)科研课题项目“UBE技术治疗腰椎管狭窄症患者手术预后及临床研究”(S20892)

摘　　要：目的:探讨单侧双通道内镜技术(unilateral bi-channel endoscopic technique,UBE)、经皮椎间孔镜技术(transforaminal endoscopic lumbar discectomy,TESSYS)治疗伴中心型肥胖的腰椎管狭窄症的临床疗效。方法:按照1∶1原则,以倾向性评分匹配法,开展回顾性研究,将我院2021年9月―2023年6月行UBE手术的51例伴中心型肥胖的腰椎管狭窄症患者作为UBE组,将同期行TESSYS手术的51例伴中心型肥胖的腰椎管狭窄症患者作为TESSYS组。比较两组术中与术后相关指标、创伤应激[活性氧、谷胱甘肽过氧化物酶(GSH-Px)、白介素-1β(IL-1β)、白介素-8(IL-8)]、腰疼和腿疼视觉模拟评分法(VAS)评分、Oswestry功能障碍指数(ODI)、Schizas标准分级、疗效良率及并发症等。结果:UBE组手术时间短于TESSYS组,术中出血、术后引流低于TESSYS组,术后下地和出院时间早于TESSYS组;UBE组术后1 d和3 d的活性氧、IL-1β、IL-8低于TESSYS组,GSH-Px高于TESSYS组;UBE组术后3 d和1个月腰疼和腿疼VAS评分、术后1个月ODI低于TESSYS组;UBE组术后1个月Schizas标准分级与TESSYS组比较差异无统计学意义;UBE组优良率(98.04%)高于TESSYS组(82.35%);两组并发症比较差异无统计学意义。结论:与TESSYS相比,UBE手术处理伴中心型肥胖的腰椎管狭窄症在手术实施、减少创伤应激、促进术后早期恢复、症状改善和功能预后方面具有优势。Objective To explore the effects of unilateral bi-channel endoscopic technique(UBE)and transforaminal endoscopic lumbar discectomy(TESSYS)on lumbar spinal stenosis with central obesity,as well as their impact on traumatic stress and complications.Methods Based on a 1∶1 matching principle,a retrospective study was conducted using the propensity score matching method.A total of 51 patients with central obesity and lumbar spinal stenosis who underwent UBE surgery in our hospital from September 2021 to June 2023 were included in the UBE group.Meanwhile,another 51 patients with central obesity and lumbar spinal stenosis who underwent TESSYS surgery during the same period were included in the TESSYS group.The study compared the surgical implementation and postoperative recovery indicators,trauma stress[reactive oxygen species,glutathione peroxidase(GSH-Px),interleukin-1β(IL-1β),interleukin-8(IL-8)],visual analog scale(VAS)scores for back pain and leg pain,Oswestry Disability Index(ODI),Schizas standard classification,excellent and good rate,and complications between the two groups.Results The operation time of UBE group was shorter than that of TESSYS group,the intraoperative bleeding and postoperative drainage were lower than that of TESSYS group,and the postoperative operation and discharge time were earlier than that of TESSYS group.The reactive oxygen species,IL-1βand IL-8 of UBE group were lower than those of TESSYS group 1 and 3 days after operation,and GSH-Px of UBE group was higher than that of TESSYS group.The VAS scores of back pain and leg pain at 3 days and 1 month after surgery and ODI at 1 month after surgery in UBE group were lower than those in TESSYS group.There was no significant difference in the standard grades of Schizas 1 month after surgery between UBE group and TESSYS group.The excellent and good rate of UBE group(98.04%)was higher than that of TESSYS group(82.35%).There was no significant difference in complications between the two groups.Conclusion Compared with TESSYS,UBE surgery has adv

关 键 词：单侧双通道内镜技术 经皮椎间孔镜技术 中心型肥胖 腰椎管狭窄症 创伤应激 功能预后 

分 类 号：R681[医药卫生—骨科学]