摘要
目的 对比单侧双通道内镜(unilateral biportal endoscopy, UBE)腰椎间盘切除术和经皮内镜椎板间入路腰椎间盘切除术(percutaneous endoscopic interlaminar discectomy, PEID)治疗腰椎间盘突出症的短期疗效。方法 回顾性分析2021年6月~2022年6月在我院住院治疗的60例腰椎间盘突出症患者的临床资料,其中UBE组29例,PEID组31例。记录两组手术时间、术中失血量、术后血红蛋白下降值、C-反应蛋白升高值、住院时间、并发症等情况。采用腰腿痛视觉模拟评分(visual analog score, VAS)、Oswestry功能障碍指数(Oswestry disability index, ODI)及改良MacNab标准进行疗效评估。结果 两组患者均手术顺利,未出现硬膜外血肿、硬膜撕裂、神经血管损伤等并发症。与UBE组相比,PEID组的手术时间、住院时间较短,术中出血量较少,血红蛋白下降值、CRP升高值较低(P<0.001)。两组患者随访3月以上,均未出现症状加重或再次手术。两组患者术后腰腿疼痛视觉模拟评分(visual analogue scale, VAS)及Oswestry功能障碍指数(Oswestry disability index, ODI)评分均较术前显著下降,但组间各时点比较无统计学差异(P>0.05)。末次随访时UBE组患者满意率为89.66%,PEID组患者满意率为90.32%,两组患者满意率差异无统计学意义(P>0.05)。结论 UBE和PEID治疗腰椎间盘突出症均可获得良好的临床疗效,但PEID在手术时间、住院时间、失血量等方面更具优势。
Objective To compare the short-term efficacy of lumbar disc herniation treated with unilateral biportal endoscopic(UBE) discectomy and percutaneous endoscopic interlaminar discectomy(PEID). Methods The clinical data of 60 patients with lumbar disc herniation from June 2021 to June 2022 were retrospectively analyzed, including 29 patients in UBE group and 31 patients in PEID group. Results The operations were successful in both groups without complications such as epidural hematoma, dural tear, neurovascular injury, etc. Compared with UBE group, PEID group had shorter operation time, shorter hospital stay, less intraoperative bleeding, lower hemoglobin reduction and CRP reduction(P<0.001). The patients were followed up for more than 3 months, and no symptoms worsened or reoperation occurred. Visual analog scale(VAS) and Oswestry disability index(ODI) were significantly lower than those before operation in both two groups, but there was no statistical difference between the groups at each time point(P>0.05). At the last follow-up, the satisfaction rate of UBE group and PEID group was 89.66% and 90.32% respectively. There was no significant difference between the two groups( P>0.05). Conclusion Both UBE and PEID have good clinical effects in the treatment of lumbar disc herniation. However,PEID has more advantages in terms of less operation time,hospital stay and blood loss.
作者
陈刚
明雨杨
夏红
何佳俊
刘浪
曹志武
李翔
俞海亮
CHEN Gang;MING Yu-yang;XIA Hong;HE Jia-jun;LIU Lang;CAO Zhi-wu;LI Xiang;YU Hai-liang(Department of Spine Surgery,Xiangtan Central Hospital,Xiangtan 411100,Hunan,China;Graduate Collaborative Training Base of Xiangtan Central Hospital,Hengyang Medical School,University of South China,Xiangtan 411100,Hunan,China)
出处
《中国现代手术学杂志》
2022年第6期444-450,共7页
Chinese Journal of Modern Operative Surgery
