摘要
目的 比较经不同椎间隙入路内镜髓核摘除术治疗腰椎间盘突出症的效果.方法 选取120例腰椎间盘突出症的患者,采取随机数字表法分为A组与B组,每组各60例,A组给予椎间孔镜经椎板间隙入路治疗,B组给予后路椎间盘镜保留黄韧带治疗,对比两组手术时间、透视次数、术中出血量、手术切口长度、视觉模拟评分法（VAS）、住院天数、手术前后Oswestey功能障碍指数（ODI）,并采用Macnab标准判断疗效.结果 A组手术时间、透视次数、术中出血量、手术切口长度、视觉模拟评分法（VAS）、住院天数分别为（58.69±5.26）min、（2.56±0.52）次、（80.23±20.45）mL、（1.63±0.33）cm、（2.95±0.77）分、（4.98±0.84）d,B组手术时间、透视次数、术中出血量、手术切口长度、视觉模拟评分法（VAS）、住院天数分别为（60.36±5.31）min、（2.55±0.48）次、（75.69±2.96）mL、（1.56±0.21）cm、（2.98±0.69）分、（5.01±0.86）d,两组手术时间、透视次数、术中出血量、手术切口长度、视觉模拟评分法（VAS）、住院天数差异无统计学意义（P＞0.05）.A组术后即刻、术后3个月ODI评分分别为（36.96±10.58）分、（9.26±0.23）分、（6.35±0.44）分,B组术后即刻、术后3个月ODI评分分别为（37.02±9.85）分、（9.42±0.65）分、（6.30±0.39）分,两组术后即刻、术后3个月ODI评分与术前相比ODI评分均较低,术后3个月与术后即刻ODI评分相比均明显降低,差异具有统计学意义（t=3.26～6.39,P＜0.05）.两组术后即刻、术后3个月ODI评分差异无统计学意义（P＞0.05）.A组优良率为90.00％,B组优良率为91.67％,两组临床优良率相比均无明显差异（P＞0.05）.结论 椎间孔镜经椎板间隙入路与后路椎间盘镜保留黄韧带治疗L5-S1腰椎间盘突出症均会取得较好的手术效果,二者无明显差异,在进行手术前需对患者的个体病情及适应症进行判断,从而选择合适的手术方法.
Objective To compare the clinical effect of different percutaneous endoscopic removal of nucleus pulposus vertebral plate gap into the road in the treatment of L5 and S1 lumbar intervertebral disc protrusion.Methods 120 cases with lumbar intervertebral disc protrusion in our hospital were randomly divided into group A and group B,60 cases in each group.Group A was given the intervertebral foramen mirror vertebral plate gap into the way,group B was given the posterior intervertebral disc mirror reserves the yellow ligament treatment.The operation time,number of perspective,intraoperative blood loss,length of incision,visual analogue scale （VAS）,hospitalization days,Oswestey disability index （ODI） before and after surgery were compared between two groups.The curative effect was evaluated by the Macnab criteria.Results The operation time,number of perspectives,intraoperative blood loss,surgical incision length,VAS score,hospitalization days in group A were （58.69±5.26）min,（2.56±0.52）times,（80.23±20.45）mL,（1.63±0.33）cm,（2.95±0.77）points,（4.98±0.84）d,respectively,those in group B were （60.36±5.31）min,（2.55±0.48）times,（75.69±2.96）mL,（1.56±0.21）cm,（2.98±0.69）points,（5.01±0.86）d,the differences between the two groups were not significant （all P〉0.05）.Immediate postoperation and postoperative 3 months,the ODI scores of group A were （36.96±10.58）points,（9.26±0.23）points,（6.35±0.44）points,respectively,and those of group B were （37.02±9.85）points,（9.42±0.65）points,（6.30±0.39）points,immediately after operation,postoperative 3 months,the ODI scores of the two groups were lower than before operation,compared with immediate postoperation,the ODI scores of postoperative 3 months were significantly reduced,the difference was statistically significant （P〈0.05）.At immediately after operation,postoperative 3 months,the ODI score between the two groups had no significant difference （P〉0.05）.The excellent rate of group A was 90.00%,which of group B was 91.67%,the difference between the two groups was not obvious （P〉0.05）.Conclusion Intervertebral foramen mirror the vertebral plate gap into the road and posterior intervertebral disc mirror reserves are yellow ligament in treatment of L5 and S1 lumbar intervertebral disc protrusion will achieve good operation effect,no obvious difference was found between the two methods,before undergoing surgery for the patients＆#39;＆#39; individual condition and indications for judgment,and to choose appropriate surgical method.
出处
《中国基层医药》
CAS
2017年第17期2695-2699,共5页
Chinese Journal of Primary Medicine and Pharmacy
关键词
椎间盘移位
椎间盘切除术
经皮
外科手术
微创性
Intervertebral disk displacement
Discectomy
percutaneous
Surgical procedures
minimally invasive
