摘要
目的比较经皮椎间孔镜髓核摘除术与低温等离子联合胶原酶髓核消融术2种手术方法在腰椎间盘突出症治疗中的临床疗效。方法回顾分析安徽医科大学第一附属医院2018年1月—2020年1月收治的72例腰椎间盘突出症患者临床资料,根据患者接受的手术方式不同将患者分为经皮椎间孔镜髓核摘除术治疗组(A组)和低温等离子联合胶原酶髓核消融术治疗组(B组),每组患者36例,比较分析A组和B组患者术后住院天数,术前、术后1周及术后1、3、6、12个月的疼痛视觉模拟评分(visual analogue scale,VAS),采用改良的MacNab标准进行手术疗效评估。结果A组和B组术后1周[A组(3.39±1.29)分,B组(4.00±1.62)分]、术后1个月[A组(2.19±0.86)分,B组(2.56±0.97)分]、术后3个月[A组(1.81±0.98)分,B组(2.25±1.00)分]、术后6个月[A组(1.36±0.64)分,B组(1.94±0.89)分]、术后12个月[A组(1.08±0.77)分,B组(1.69±0.79)分]与术前[A组(6.75±1.20)分,B组(7.00±1.17)分]相比,VAS评分均显著降低(均P<0.05)。结论经皮椎间孔镜髓核摘除术与低温等离子联合胶原酶髓核消融术在腰椎间盘突出症的治疗中均可取得满意的近期疗效,能够显著缓解患者疼痛症状,改善患者生活质量,二者相比经皮椎间孔镜髓核摘除术远期效果更优。
Objective To compare the clinical effect of percutaneous transforaminal endoscopic discectomy(PTED)and low-temperature plasma-mediated radiofrequency ablation combined with collagenase in the treatment of lumbar disc herniation(LDH).Methods Total 72 patients who were treated with LDH in the First Affiliated Hospital of Anhui Medical University from January 2018 to January 2020 were retrospectively analysed.The patients were divided into two groups:group A(36 patients treated with PTED)and group B(36 patients treated with low-temperature plasma-mediated radiofrequency ablation combined with collagenase).The postoperative hospital stay and visual analogue scale(VAS)score at different time points were compared between the two groups.The modified MacNab criteria were used to evaluate the clinical efficacy.Results Compared to preoperatively[A:(6.75±1.20)points,B:(7.00±1.17)points],the VAS score of both groups decreased significantly at 1 week[A:(3.39±1.29)points,B:(4.00±1.62)points],1 month[A:(2.19±0.86)points,B:(2.56±0.97)points],3 months[A:(1.81±0.98)points,B:(2.25±1.00)points],6 months[A:(1.36±0.64)pointa,B:(1.94±0.89)points]and 12 months[A:(1.08±0.77),B:(1.69±0.79)points]after surgery(all P<0.05).Conclusion PTED and low-temperature plasma-mediated radiofrequency ablation combined with collagenase could achieve satisfactory short-term effects in the treatment of LDH.Both surgical techniques could significantly alleviate the pain symptoms and improve the quality of life,whilst PTED could achieve better long-term effect.
作者
赵龙
张荣宜
刘畅
ZHAO Long;ZHANG Rong-yi;LIU Chang(Department of Pain Management,the First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China)
出处
《中华全科医学》
2021年第11期1827-1830,共4页
Chinese Journal of General Practice
基金
安徽高校自然科学研究项目(KJ2018A0661)。
关键词
腰椎间盘突出症
经皮椎间孔镜髓核摘除术
低温等离子联合胶原酶髓核消融术
疗效
Lumbar disc herniation
Percutaneous transforaminal endoscopic discectomy
Low-temperature plasma-mediated radiofrequency ablation combined with collagenase
Clinical efficacy
