经皮脊柱内镜下腰椎间盘摘除术治疗腰椎间盘突出症的疗效研究  

Study of the efficacy of percutaneous endoscopic lumbar discectomy for the treatment of lumbar intervertebral disc herniation

作　　者：包晓赫 张钟元 BAO Xiao-he;ZHANG Zhong-yuan(Shenyang Medical College Affiliated Central Hospital,Shenyang 110024,China)

机构地区：[1]沈阳医学院附属中心医院,110024

出　　处：《中国实用医药》2025年第6期59-62,共4页China Practical Medicine

摘　　要：目的 分析针对腰椎间盘突出症(LDH)患者行经皮脊柱内镜下腰椎间盘摘除术(PELD)治疗的效果。方法 68例LDH患者,随机分为对照组和观察组,每组34例。对照组行开放椎板开窗术治疗,观察组行PELD治疗。对比两组手术指标、炎症指标[白细胞计数(WBC)、C反应蛋白(CRP)、血沉(ESR)]、视觉模拟评分法(VAS)评分、腰椎功能。结果 观察组手术时间(60.03±4.23)min、下床活动时间(1.66±0.17)d、住院时间(4.11±0.31)d明显短于对照组的(68.84±5.98)min、(4.01±0.52)d、(7.37±1.26)d,术中出血量(23.34±2.28)ml少于对照组的(73.67±4.22)ml(P<0.05)。术后,观察组WBC(17.22±1.23)×10^(9)/L、CRP(12.26±1.17)mg/L、ESR(24.15±2.04)mm/h明显低于对照组的(22.85±1.74)×10^(9)/L、(17.75±1.33)mg/L、(31.89±2.54)mm/h(P<0.05)。术后12、24、48 h,观察组VAS评分分别为(5.01±1.02)、(2.96±0.37)、(1.92±0.11)分,均低于对照组的(6.87±1.34)、(4.28±0.47)、(2.76±0.17)分(P<0.05)。术后,观察组日本骨科协会评估治疗分数(JOA)中主观症状、临床体征、日常活动受限评分及总分分别为(7.04±1.12)、(4.76±0.45)、(11.78±1.18)、(23.58±2.75)分,均高于对照组的(5.27±1.08)、(2.67±0.32)、(8.97±1.05)、(16.91±2.45)分(P<0.05)。结论 采用PELD对LDH患者进行治疗,可改善手术相关指标和炎症反应,降低疼痛程度,使腰椎功能快速恢复。Objective To analyze the effect of percutaneous endoscopic lumbar discectomy (PELD) for the treatment of lumbar intervertebral disc herniation (LDH).Methods 68 patients with LDH were randomly divided into a control group and an observation group,each with 34 cases.The control group underwent open laminotomy,and the observation group underwent PELD therapy.Comparison of surgical indicators,inflammatory indicators[white blood cell count (WBC),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR)],visual analogue scale (VAS) score and lumbar function between the two groups.Results The operation time of the observation group was (60.03±4.23) min,the ambulation time was (1.66±0.17) d and the hospitalization time was (4.11±0.31) d,which were significantly shorter than (68.84±5.98) min,(4.01±0.52) d and (7.37±1.26) d of the control group;the observation group had a less intraoperative blood loss of (23.34±2.28) ml than (73.67±4.22) ml of the control group (P<0.05).After operation,the observation group had WBC of (17.22±1.23)×10^(9)/L,CRP of (12.26±1.17) mg/L and ESR of (24.15±2.04) mm/h,which were significantly lower than(22.85±1.74)×10^(9)/L,(17.75±1.33) mg/L and (31.89±2.54) mm/h in the control group (P<0.05).At 12,24 and48 h after operation,VAS scores of the observation group were (5.01±1.02),(2.96±0.37) and (1.92±0.11) points,which were lower than (6.87±1.34),(4.28±0.47) and (2.76±0.17) points of the control group (P<0.05).After operation,the subjective symptoms,clinical signs,daily activity restriction scores and total scores on Japanese Orthopaedic Association (JOA) in the observation group were (7.04±1.12),(4.76±0.45),(11.78±1.18) and(23.58±2.75) points,which were higher than (5.27±1.08),(2.67±0.32),(8.97±1.05) and (16.91±2.45) points in the control group (P<0.05).Conclusion PELD treatment of LDH patients can improve the operation-related indications and inflammation,reduce the pain severity,quickly restore the lumbar spine function.

关 键 词：腰椎间盘突出症 经皮脊柱内镜下腰椎间盘摘除术 开放椎板开窗术 临床疗效 

分 类 号：R687.3[医药卫生—骨科学]