摘要
目的探讨经皮椎间孔镜腰椎间盘切除术(percutaneous endoscopic lumbar discectomy,PELD)治疗腰椎间盘突出症的效果。方法选取102例腰椎间盘突出症患者,按照随机数字表法分为观察组与对照组,各51例。对照组行椎板开窗椎间盘切除术(fenestration discectomy,FD),观察组行PELD术,比较2组患者临床疗效、手术情况及腰腿疼痛程度。结果观察组和对照组的手术优良率分别为92.15%、88.23%,差异无统计学意义(P>0.05);观察组切口长度为(0.68±0.24)cm,短于对照组的(4.26±0.57)cm,术中出血量为(31.42±4.58)mL,少于对照组的(82.49±8.76)mL,住院时间为(6.52±1.43)d,短于对照组的(9.87±2.69)d,差异均有统计学意义(P<0.05);观察组术后各时段(术后1、3、6、12个月)视觉模拟评分法(VAS)依次为(2.83±0.97)分、(2.16±0.85)分、(1.12±0.56)分、(0.68±0.27)分,低于对照组的(4.29±1.13)分、(3.28±1.04)分、(2.13±0.74)分、(1.25±0.43)分,差异均有统计学意义(P<0.05)。结论PELD治疗腰椎间盘突出症的疗效确切,且可有效减小手术切口,减少术中出血量,缩短患者住院时间,减轻腰腿疼痛程度。
Objective To investigate the efficacy of percutaneous endoscopic lumbar discectomy(PELD)in the treatment of lumbar intervertebral disc herniation.Methods 102 patients of lumbar intervertebral disc herniation in the hospital were selected and divided into two groups by random number table,51 cases each.The control group was treated with fenestration discectomy(FD),while the observation group was treated with PELD.The clinical efficacy,surgical condition,and the degree of lumbocrural pain were compared between the two groups.Results The excellent rates of operation in the observation group and the control group were 92.16%and 88.24%,respectively,with no significant difference(P>0.05).The length of incision in observation group[(0.68±0.24)cm]was shorter than that in control group[(4.26±0.57)cm].The intraoperative blood loss of observation group[(31.42±4.58)ml]was less than that of control group[(82.49±8.76)mL].The length of hospitalization in observation group[(6.52±1.43)d]were shorter than those in control group[(9.87±2.69)d].There were statistical significances in the comparison of all above indexes(P<0.05).The visual analogue score(VAS)[(2.83±0.97)points,(2.16±0.85)points,(1.12±0.56)points,(0.68±0.27)points]of observation group were lower than those of control group[(4.29±1.13)points,(3.28±1.04)points,(2.13±0.74)points,(1.25±0.43)points]and the difference was statistically significant(P<0.05).Conclusion PELD in the treatment of lumbar intervertebral disc herniation is effective.It can reduce the surgical incision,decrease intraoperative blood loss,shorten the length of hospitalization and reduce the degree of lumbocrural pain.
作者
效伟
XIAO Wei(Department of Orthopedic Surgery,Luohe Central Hospital,Luohe Henan 462300,China)
关键词
腰椎间盘突出症
经皮椎间孔镜腰椎间盘切除术
腰腿疼痛程度
lumbar intervertebral disc herniation
percutaneous endoscopic lumbar discectomy
degree of lumbocrural pain
