经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症患者的临床效果分析  

Analysis of Clinical Effect of Percutaneous Endoscopic Lumbar Discectomy in Patients with Lumbar Disc Herniation

作　　者：许伟阳 肖方烛 XU Weiyang;XIAO Fangzhu(Department of Orthopedics,the Fifth Hospital of Xiamen,Xiamen 361000,China)

机构地区：[1]福建省厦门市第五医院骨科,福建厦门361000

出　　处：《中国伤残医学》2025年第7期23-27,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨经皮椎间孔镜下髓核摘除术(PELD)对腰椎间盘突出症(LDH)患者脊柱稳定性的影响。方法:选取2022年1月—2023年12月厦门市第五医院收治的68例LDH患者为研究对象,采用随机数表法将其分为对照组及探究组,每组34例。对照组行椎板开窗髓核摘除术治疗,探究组行PELD治疗。对比两组围手术期指标、脊柱稳定性、腰椎功能障碍程度及并发症发生情况。结果:探究组的手术时间、切口长度、术后首次下床时间及住院时间均短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05)。术后3个月,探究组的腰椎曲度、腰椎前凸角度及腰骨倾斜角均大于对照组,差异均有统计学意义(P<0.05)。术后1、4、8周,探究组的腰椎日本骨科协会评分均高于对照组,差异均有统计学意义(P<0.05)。探究组的并发症发生率为5.88%,低于对照组的23.53%,差异有统计学意义(P<0.05)。结论:PELD治疗LDH具有明显优势,不仅能有效减少手术创伤和术后恢复时间,还能更好地维持患者的脊柱稳定性,促进腰椎功能恢复。Objective:To investigate the effect of percutaneous endoscopic lumbar discectomy(PELD)on spinal stability in patients with lumbar disc herniation(LDH).Methods:A total of 68 LDH patients admitted to the Fifth Hospital of Xiamen from January 2022 to December 2023 were selected as the research objects,and were divided into a control group and an exploration group by random number table method,with 34 cases in each group.The control group treated with fenestration of laminae nucleus pulposus and the exploration group treated with PELD.The perioperative indexes,spinal stability,degree of lumbar dysfunction and complications were compared between the two groups.Results:The operation time,incision length,the first time getting out of bed and hospitalization time in the exploration group were shorter than those in the control group,and the intraoperative blood loss was less than that in the control group,the differences were statistically significant(P<0.05).Three months after operation,the lumbar curvature,lumbar lordosis angle and lumbar bone inclination angle in the exploration group were greater than those in the control group,the differences were statistically significant(P<0.05).At 1,4 and 8 weeks after surgery,the lumbar Japanese Orthopaedic Association scores in the exploration group were higher than those in the control group,the differences were statistically significant(P<0.05).The incidence of complications in the exploration group was 5.88%,which was lower than 23.53%in the control group,and the difference was statistically significant(P<0.05).Conclusion:PELD has obvious advantages in the treatment of LDH,not only can effectively reduce surgical trauma and postoperative recovery time,but also can better maintain the spinal stability of patients and promote the recovery of lumbar function.

关 键 词：经皮椎间孔镜下髓核摘除术 腰椎间盘突出症 椎板开窗髓核摘除术 脊柱稳定性 

分 类 号：R687.3[医药卫生—骨科学]