摘要
目的比较椎间孔镜微创手术与开放性手术治疗单节段腰椎间盘突出的疗效。方法前瞻性选择88例单节段腰椎间盘突出患者,随机分为观察组与对照组,各44例。观察组采用经椎间孔内镜脊柱系统(TESSYS)进行手术,对照组采取开放性单纯髓核摘除术。比较两组手术时间、切口大小、术中出血量、卧床时间、住院时间、恢复工作时间,术后第1天、术后第3天、术后第5天、术后第7天的切口疼痛视觉模拟评分(VAS),术前与术后1周、3个月、6个月不同时间点的脊柱Oswestrv功能障碍指数(ODI),术后并发症发生率与术后6个月的手术优良率。结果观察组手术时间、切口长度、术中出血量、卧床时间、住院时间及恢复工作时间均短于对照组(P<0.05)。两组术后不同时点的切口疼痛VAS评分均逐渐降低(P<0.05),观察组术后不同时间点的切口疼痛VAS评分均低于对照组(P<0.05)。两组术后不同时点的ODI评分均显著低于术前(P<0.05),但手术前后两组ODI评分的组间差异无统计学意义(P>0.05)。观察组的红外线热成像总有效率为93.18%(41/44),对照组为88.64%(39/44),差异无统计学意义(P>0.05)。观察组与对照组的并发症总发生率分别为6.82%与11.36%,手术优良率分别为90.91%与86.36%,差异均无统计学意义(P>0.05)。结论 TESSYS与开放性手术治疗单节段腰椎间盘突出症的疗效相当,但前者具有微创性,术中出血少、术后切口疼痛减轻,恢复快,值得推广。
Objective To compare the effect of minimally invasive surgery and open surgery on single-segment lumbar disc herniation.Methods A total of 88 cases of single segment lumbar disc herniation patients were selected and were divided into observation group and control group randomly,44 cases in each group. The observation group was treated with transforaminal endoscopic spine system（ TESSYS）,and the control group was treated with open and simple nucleus pulposus. The operation time,incision size,intraoperative blood loss,bedridden time,hospitalization time,time of resuming work,visual analogue scale（ VAS） at different time points after operation,the Oswestrv dysfunction index（ ODI）of the spine at different time points before and after surgery,the incidence of postoperative complications and the excellent rate of surgery after 6 months were compared between two groups. Results The operation time,incision length,intraoperative blood loss,bedridden time,hospitalization time,time of resuming work were shorter in the observation group than those in the control group（ P〈0. 05）. The VAS scores of the incision pain at different time points after operation were gradually decreased（ P〈0. 05）,and the VAS score of the incision pain at different time points in the observation group after operation were lower than those in the control group（ P〈0. 05）. The ODI scores of the two groups were significantly lower than those before operation（ P〈0. 05）,but there was no significant difference between the two groups before and after operation（ P〈0. 05）. The total effective rate of infrared thermal imaging in the observation group was 93. 18%（ 41/44） and 88. 64%（ 39/44） in the control group,the difference was not statistically significant（ P〈0. 05）. The incidence of postoperative complications of the observation group and the control group were 6. 82% and 11. 36% respectively,and the excellent and good rate of operation was 90. 91% and 86. 36% respectively,the difference was not statistically significant（ P〈0. 05）. Conclusion The effect of TESSYS and open surgery for single-segment lumbar disc herniation is relatively the same,but the former has the advantage of minimally invasive,less intraoperative bleeding,postoperative incision pain relief,quick recovery,and it is worth promoting.
作者
孙亚文
徐南伟
何劲
谢华
SUN Ya-wen;XU Nan-wei;HE Jin(Department of Orthopedics,Affiliated Jintan Hospital of Jiangsu University,Jintan District People＇s Hospital,Changzhou Jiangsu 213200,China;Department of Spine Surgery,Changzhou Second People＇s Hospital,Changzhou Jiangsu 213000,China.)
出处
《临床和实验医学杂志》
2018年第15期1663-1667,共5页
Journal of Clinical and Experimental Medicine
关键词
单节段腰椎间盘突出
椎间孔镜微创手术
开放性手术
对比研究
Single segment lumbar disc herniation
Transforaminal endoscopic microinvasive surgery
Open surgery
Comparative study
