摘要
目的探讨经皮内镜椎间孔入路椎间盘切除术(transforaminal percutaneous endoscopic lumbar discectomy,TF-PELD)治疗腰椎间盘突出症(lumbar disc heniation,LDH)的临床效果及安全性。方法回顾性分析2016年1月至2017年2月,我院收治的70例LDH患者的临床资料,其中34例采用TF-PELD治疗(观察组),36例采用开放性手术(对照组),术后随访6个月,随访率100%,评价并分析两组手术指标和治疗效果。结果观察组手术时间长于对照组[(65.3±7.2)min vs.(58.4±6.4)min],但出血量[(47.3±8.5)ml vs.(142.4±12.3)ml]、下床活动时间[(1.6±0.5)天vs.(13.4±2.4)天]和住院时间[(4.9±1.5)天vs.(16.2±3.9)天]均少于对照组,差异有统计学意义(P<0.05)。两组患者术后3个月和6个月时的疼痛视觉模拟评分(visual analogue scale,VAS)和Oswestry功能障碍指数(oswestry disability index,ODI)评分均显著低于术前,差异有统计学意义(P<0.05);观察组术后3个月(2.41±0.82 vs.4.34±0.93)和术后6个月(1.61±0.56vs.2.17±0.78)的VAS显著低于对照组,差异有统计学意义(P<0.05);观察组术后3个月(23.27±7.79 vs.35.47±8.24)和术后6个月(14.45±3.47 vs.18.66±5.18)的ODI评分显著低于对照组,差异有统计学意义(P<0.05)。观察组和对照组Mac Nab疗效优良率分别为91.18%和69.44%,差异有统计学意义(P<0.05)。结论 TF-PELD治疗LDH安全有效、术后恢复快、并发症少,值得临床推广。
Objective To investigate the clinical effects and safety of transforaminal percutaneous endoscopic lumbar discectomy(TF-PELD） in the treatment of lumbar disc heniation(LDH）. Methods The clinical data of 70 patients with LDH, admitted from January 2016 to February 2017, were analyzed retrospectively. Among them, 34 patients were treated with TF-PELD(observation group） and 36 patients were treated with open surgery(control group）. After a follow-up of 6 months, the follow-up rate was 100%. The surgical indexes and treatment effects were evaluated and analyzed. Results The operative time of the observation group was significantly longer than that of the control group [(65.3 ± 7.2） min vs.(58.4 ± 6.4） min ](P 0.05）. The amount of bleeding [(47.3 ± 8.5） ml vs.(142.4 ± 12.3） ml ] was significantly less than those in the control group(P 0.05）. The time for getting out of bed [(1.6 ± 0.5） d vs.(13.4 ± 2.4） d ] and hospital stay [(4.9 ± 1.5） d vs.(16.2 ± 3.9） d ] were significantly shorter than those in the control group(P 0.05）. The VAS and ODI scores 3 months and 6 months after operation in both groups were significantly lower than those before operation with statistically significance(P 0.05）. The VAS scores in the observation group 3 months after operation(2.41 ± 0.82 vs. 4.34 ± 0.93） and 6 months after operation(1.61 ± 0.56 vs.2.17 ± 0.78） were significantly lower than those in the control group with statistical significance(P 0.05）. The ODI scores of observation group 3 months after operation(23.27 ± 7.79 vs. 35.47 ± 8.24） and 6 months after operation(14.45 ± 3.47 vs. 18.66 ± 5.18） were significantly lower than those in control group with statistical significance(P 0.05）. The excellent and good rates of Mac Nab in observation group and control group were 91.18% and 69.44% respectively. The differences were statistically significant(P 0.05）. Conclusions TF-PELD is safe and effective with quick recovery. It causes less complications in the treatment of LDH.
作者
王江南
韩山山
陈亮
黄干
WANG Jiang-nan;HAN Shan- shan;CHEN Liang;HUANG Gan.(Department of Orthopedics, the second People＇s Hospital of Lu ＇an City, Lu ＇an, Anhui, 237000, Chin)
出处
《中国骨与关节杂志》
CAS
2018年第5期384-388,共5页
Chinese Journal of Bone and Joint
关键词
椎间孔镜
腰椎间盘突出症
疗效
安全性
Transforaminal percutaneous endoscopic
LDH
Efficacy
Safety
