腰椎间盘突出症患者行脊柱内镜下经椎间孔入路手术的治疗效果及其影响因素分析  

Analysis of the Therapeutic Effect and Its Influencing Factors of Transforaminal Approach Surgery under Spinal Endoscopy for Patients with Lumbar Intervertebral Disc Protrusion

作　　者：罗维江 LUO Weijiang(Department of Orthopaedics,Baiyin Second People’s Hospital,Baiyin,730900,China)

机构地区：[1]白银市第二人民医院骨科,甘肃白银730900

出　　处：《反射疗法与康复医学》2025年第7期116-118,132,共4页Reflexology And Rehabilitation Medicine

摘　　要：目的探讨腰椎间盘突出症(LDH)患者行脊柱内镜下经椎间孔入路手术的治疗效果及其影响因素。方法选取2021年5月—2024年6月白银市第二人民医院收治的105例LDH患者为研究对象,均行脊柱内镜下经椎间孔入路手术治疗,并随访3个月,依据手术效果分为有效组及无效组,收集所有患者年龄、性别、体质指数、病程、腰椎外伤史、突出物钙化、腰椎滑脱、椎管形态、突出位置等多方面基础资料,开展Logistic回归分析,获得影响患者术后疗效的危险因素。结果105例患者经脊柱内镜下经椎间孔入路手术治疗后,优、良、可、差例数分别为37例、45例、18例、5例;其中有效组为82例,无效组为23例。单因素分析结果显示,两组体质指数、病程、突出物钙化、椎管形态比较,组间差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,体质指数≥24.0 kg/m^(2)[OR(95%CI)=3.250(1.234~8.561)]、病程≥6个月[OR(95%CI)=4.427(1.579~12.414)]、突出物钙化[OR(95%CI)=3.545(1.360~9.244)]、椎管形态三叶草形[OR(95%CI)=3.382(1.294~8.840)]为影响LDH行脊柱内镜下经椎间孔入路手术患者术后疗效的危险因素(OR>1,P<0.05)。结论LDH行脊柱内镜下经椎间孔入路手术患者的术后疗效受体质指数≥24.0 kg/m^(2)、病程≥6个月、突出物钙化、椎管形态三叶草形影响大,还需术前做好评估,完善手术方案,更好改善患者预后。Objective To explore the therapeutic effect of endoscopic transforaminal approach surgery for patients with lumbar disc herniation(LDH)and its influencing factors.Methods A total of 105 LDH patients admitted to the Baiyin Second People’s Hospital from May 2021 to June 2024 were selected as the research subjects.All patients underwent endoscopic percutaneous endoscopic lumbar discectomy surgery and were followed up for 3 months.According to the surgical effect,they were divided into an effective group and an ineffective group.Basic data such as age,gender,body mass index,disease course,history of lumbar spine trauma,calcification of protrusions,lumbar spondylolisthesis,spinal canal morphology,and protrusion location were collected from all patients.Logistic regression analysis was conducted to obtain risk factors affecting postoperative efficacy.Results Among the 105 patients treated with endoscopic percutaneous endoscopic lumbar discectomy,the numbers of excellent,good,fair,and poor cases were 37,45,18,and 5,respectively;among them,there were 82 cases in the effective group and 23 cases in the ineffective group.The results of univariate analysis showed that there were statistically significant differences between the two groups in body mass index,disease duration,protrusion calcification,and spinal canal morphology(P<0.05).The results of multiple Logistic regression analysis showed that body mass index≥24.0 kg/m^(2)[OR(95%CI)=3.250(1.234~8.561)],disease duration≥6 months[OR(95%CI)=4.427(1.579~12.414)],protrusion calcification[OR(95%CI)=3.545(1.360~9.244)],and spinal canal morphology clover shaped[OR(95%CI)=3.382(1.294~8.840)]were risk factors affecting the postoperative efficacy of LDH patients undergoing endoscopic transforaminal surgery(OR>1,P<0.05).Conclusion The postoperative efficacy of percutaneous endoscopic lumbar discectomy for LDH patients is greatly affected by body mass index≥24.0 kg/m^(2),disease duration≥6 months,calcification of protrusions,and clover shaped spinal canal morphology.Preope

关 键 词：腰椎间盘突出症 经椎间孔入路手术 临床疗效 影响因素 

分 类 号：R68[医药卫生—骨科学]