摘要
目的观察经皮椎间孔镜对复发性腰椎间盘突出症合并腰椎后凸畸形患者的治疗效果及对其细胞因子的影响。方法选取复发性腰椎间盘突出症合并腰椎后凸畸形患者64例,随机分为2组,对照组应用传统椎板开窗术治疗,研究组应用经皮椎间孔镜椎间盘切除术治疗。结果研究组治疗效果和总有效率优于对照组(P<0.05)。研究组手术时间明显长于对照组,术中出血量明显小于对照组,术后卧床时间明显短于对照组(P<0.05)。治疗后2组视觉模拟评分法(Visual Analogue Scale,VAS)评分和Oswestry功能指数(Oswestry Dability Index,ODI)评分均较治疗前明显降低,研究组VAS评分和ODI评分均较对照组更低(P<0.05)。研究组并发症发生率低于对照组(P<0.05)。治疗后2组超敏C反应蛋白(high sensitive C-reactive protein,hs-CRP)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)与白细胞介素6(interleukin-6,IL-6)水平均比治疗前降低,研究组hs-CRP、TNF-α与IL-6水平均较对照组更低,差异有统计学意义(P<0.05)。结论在针对复发性腰椎间盘突出症合并腰椎后凸畸形的治疗过程中,经皮椎间孔镜椎间盘切除术治疗效果理想,损伤小,可有效改善炎症因子水平,促进患者快速康复,值得在临床上进一步推广应用。
Objective To investigate the effect of percutaneous foramen microscopy on the treatment of recurrent lumbar disc herniation complicated with kyphosis and its effect on cytokines.Methods Sixty four patients with recurrent lumbar disc herniation combined with lumbar kyphosis were randomly divided into 2 groups.The control group was treated with traditional laminectomy,while the study group was treated with percutaneous foraminal discectomy.Results The therapeutic effect and total effective rate of the study group were better than that of the control group(P<0.05).The operation time of the study group was significantly longer than that of the control group,the intraoperative blood loss was significantly smaller than that of the control group,and the postoperative bed time was significantly shorter than that of the control group(P<0.05).After treatment,Visual Analogue Scale(VAS)score and Oswestry Dability Index(ODI)score in both groups were significantly lower than that before treatment,and both VAS score and ODI score in the study group were lower than those in the control group(P<0.05).The incidence of complications in the study group was lower than that in the control group(P<0.05).High sensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels in both groups were lower after treatment than that before treatment,while hs-CRP,TNF-αand IL-6 levels in the study group were lower than those in the control group.The difference was statistically significant(P<0.05).Conclusion In the treatment of recurrent lumbar disc herniation combined with lumbar kyphosis deformity,percutaneous foraminal discectomy has an ideal therapeutic effect with small damage,which can effectively improve the level of inflammatory factors and promote the rapid recovery of patients,and can be further popularized in clinical practice.
作者
郑义朋
沈丹平
王谦
周医斋
段礼鹏
马国驹
ZHENG Yi-peng;SHEN Dan-ping;WANG Qian;ZHOU Yi-zhai;DUAN Li-peng;MA Guo-ju(Department of Orthopaedics,the Second Central Hospital of Baoding,Hebei Province,Baoding 072750,China)
出处
《河北医科大学学报》
CAS
2019年第12期1405-1408,1420,共5页
Journal of Hebei Medical University
关键词
腰椎间盘突出
腰椎后凸畸形
经皮椎间孔镜技术
lumbar disc herniation
lumbar kyphosis deformity
percutaneous foramina technique
