摘要
目的:分析经皮椎间孔镜BEIS技术对老年腰椎间盘突出症(LDH)患者应激反应及神经功能恢复的影响。方法:选择皖南医学院第二附属医院骨科2016年6月~2020年6月84例老年LDH患者,以双盲随机抽样法分为两组(各42例),观察组采用经皮椎间孔镜BEIS技术治疗,对照组采用传统椎板开窗减压髓核摘除术(FD)治疗,对比两组手术指标、应激反应指标、视觉模拟评分量表(VAS)评分、JOA评分、并发症发生率。结果:观察组术中出血量及住院时间均优于对照组,但手术时间长于对照组(P<0.05)。观察组术后3 d血清ACTH、INS、Cor水平均低于对照组,差异有统计学意义(P<0.05)。两组术后3 d VAS评分均低于术前,而JOA评分均高于术前;且观察组评分优于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率(2.38%)虽低于对照组(16.67%),但差异无统计学意义(P>0.05)。结论:经皮椎间孔镜BEIS技术治疗老年LDH虽然手术时间较长,但术后应激反应、疼痛感较轻,神经功能恢复良好,并发症少,值得借鉴。
Objective:To observe the effect of percutaneous transforaminal endoscopic discectomy(PTED)by broad-easy-and-immediate-surgery(BEIS)on the stress level and recovery of neurological function in elderly patients with lumbar disc herniation(LDH).Methods:Eighty-four elderly cases of LDH treated in our department were included from June 2016 to June 2020,and divided into observational group and control group by double-blind random sampling(n=42 in each group).Patients in the observational group received PTED by BEIS,and those in the control group were treated by conventional fenestration discectomy(FD)of the vertebral plate and removal of the nucleus pulposus.Then the two groups were compared pertinent to the surgical indicators,stress response,scoring on VAS and JOA as well as complication rate.Results:Patients in the observational group had lower intraoperative blood loss,shorter hospital stay,yet longer operative time than those in the control group(all P<0.05).The serum ACTH,INS and Cor levels were lower in observational group than in control group at day 3 after surgery(all P<0.05).The VAS scoring was lower and JOA was higher at day 3 following operation in the two groups,and the scoring on the two indicators was better in observational group than in control group(P<0.05).Although the incidence of complication was lower in the observational group(2.38%)than that in the control(16.67%),yet the difference remained insignificant(P>0.05).Conclusion:Although PTED performed by BEIS technique takes longer time in treatment of elderly patients of LDH,yet this surgical modality is worthy of wider recommendation because of its lower stress response,reduced pain,better recovery of neurological function and fewer complications.
作者
钟如意
裴付来
黄昌佳
万张辉
茆平
ZHONG Ruyi;PEI Fulai;HUANG Changjia;WAN Zhanghui;MAO Ping(Department of Orthopaedics,The Second Affiliated Hospital of Wannan Medical College,Wuhu 241000,China)
出处
《皖南医学院学报》
CAS
2021年第4期358-361,共4页
Journal of Wannan Medical College
基金
芜湖市科技计划项目(2020ms3-10)。
