摘要
目的探讨单边双通道脊柱内镜技术(unilateral biportal endoscopy,UBE)与经皮椎板间入路腰椎间盘髓核摘除术(percutaneous endoscopic interlaminar discectomy,PEID)治疗游离型腰椎间盘突出症(lumbar disc herniation,LDH)对患者术后腰背功能恢复的影响。方法选择2018年6月至2020年6月在新乡医学院第一附属医院确诊的游离型LDH患者86例,采用简单随机分组法将所有纳入LDH患者随机分为对照组和观察组,对照组采用PEID治疗,观察组采用UBE治疗,每组均为43例。以改良MacNab标准评价临床疗效。记录患者的手术时间、失血量、术后住院时间。采用视觉模拟评分法(visual analogue scale,VAS)和Roland-Morris功能障碍调查表(Roland-Morris dysfunction questionnaire,RMDQ)评估患者术前、术后1个月及术后6个月的腰背疼痛和功能障碍情况。记录患者术后并发症的发生情况。结果观察组LDH患者治疗的优良率为95.35%,对照组治疗的优良率为93.03%,两组差异无统计学意义(P>0.05);观察组的住院时间少于对照组(P<0.05);观察组和对照组术后3个月、6个月的VAS与RMDQ评分均低于术前(P<0.05),且观察组术后3个月和术后6个月的VAS与RMDQ评分明显低于对照组(P<0.05);观察组的术后并发症发生率为9.31%,与对照组的4.66%比较差异无统计学意义(P>0.05)。结论UBE可以安全有效提高LDH患者治疗的临床疗效,缓解LDH患者的疼痛症状,有利于恢复腰背功能。
Objective To explore the effects of unilateral biportal endoscopy(UBE)and percutaneous endoscopic interlaminar discectomy(PEID)on postoperative recovery of low back function in patients with free lumbar disc herniation(LDH).Methods A total of 86 patients with free LDH confirmed in the hospital were enrolled between June 2018 and June 2020.According to simple random grouping method,they were divided into control group(PEID)and observation group(UBE),43 cases in each group.The clinical curative effect was evaluated by modified MacNab standards.The operation time,blood loss and postoperative hospitalization time were recorded.The low back pain and dysfunction were assessed by visual analogue scale(VAS)and Roland-Morris dysfunction questionnaire(RMDQ)before surgery,at 1 month and 6 months after surgery.The occurrence of postoperative complications was recorded.Results The difference in good rate of clinical curative effect between observation group and control group was not statistically significant(95.35%vs 93.03%)(P>0.05).The hospitalization time in observation group was shorter than that in control group(P<0.05).At 3 and 6 months after surgery,scores of VAS and RMDQ were lower than those before surgery in both groups(P<0.05),which were significantly lower in observation group than control group(P<0.05).The difference in incidence of postoperative complications between observation group and control group was not statistically significant(9.31%vs 4.66%)(P>0.05).Conclusion UBE can safely and effectively improve clinical curative effect and relieve pain in LDH patients,which is conducive to the recovery of low back function.
作者
王善坤
杨利斌
柳申鹏
王亚琦
WANG Shan-kun;YANG Li-bin;LIU Shen-peng;WANG Ya-qi(Department of Orthopedics,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang,Henan 453100,China)
出处
《医药论坛杂志》
2022年第5期28-31,共4页
Journal of Medical Forum
