经皮椎间孔镜TESSYS技术治疗单节段钙化型腰椎间盘突出症的临床疗效分析
|
摘要
目的总结性分析微创经皮椎间孔镜髓核摘除(TESSYS)技术治疗钙化型腰椎间盘突出症(CLDH)的疗效。方法将2015年1月至2017年7月该院脊柱外科收治的CLDH患者38例分为常规组(18例)和孔镜组(20例),分别给予传统椎板开窗髓核摘除术及经皮椎间孔镜TESSYS技术治疗,比较两组患者的临床疗效。结果孔镜组患者术口长度、失血量、引流量、手术时间、术后绝对卧床时间、住院时间、住院总费用均明显少于常规组,差异均有统计学意义(P<0.05)。两组患者Mac Nab疗效判定标准的优良率比较,差异无统计学意义(P>0.05)。结论对CLDH患者的治疗,经皮椎间孔镜TESSYS技术与传统开窗术均具有相似的临床效果,但经皮椎间孔镜TESSYS技术具有创伤小、术后恢复快等优点,值得临床推广应用。
Objective To explore and analysis the efficacy of transforaminal endoscopic spine system(TESSYS)in the treatment of calcified lumbar disc herniation(CLDH).Methods 38 patients with CLDH in our hospital from January 2015 to July 2017 were divided into two group,one was routine group(n=18)and the other was TESSYS group(n=20).The routine group was treated with traditional laminectomy and the TESSYS group was treated with TESSYS.We compared the clinical effects between the two groups.Results The length of incision,the amount of blood lost during operation,the postoperative drainage,the operative time,the time of stay in bed and the length of stay in hospital,the total hospitalization costs were lower in the TESSYS group than those in the routine group.The differences between the two groups were statistically significant(P<0.05).Conclusion Compared with the traditional fenestration,the TESSYS technique has similar clinical effect on the treatimebt if CLDHG patients,but it has the advantages of less trauma and quick recovery after operation,so it is worth popularizing in clinic.
Objective To explore and analysis the efficacy of transforaminal endoscopic spine system(TESSYS)in the treatment of calcified lumbar disc herniation(CLDH).Methods 38 patients with CLDH in our hospital from January 2015 to July 2017 were divided into two group,one was routine group(n=18)and the other was TESSYS group(n=20).The routine group was treated with traditional laminectomy and the TESSYS group was treated with TESSYS.We compared the clinical effects between the two groups.Results The length of incision,the amount of blood lost during operation,the postoperative drainage,the operative time,the time of stay in bed and the length of stay in hospital,the total hospitalization costs were lower in the TESSYS group than those in the routine group.The differences between the two groups were statistically significant(P<0.05).Conclusion Compared with the traditional fenestration,the TESSYS technique has similar clinical effect on the treatimebt if CLDHG patients,but it has the advantages of less trauma and quick recovery after operation,so it is worth popularizing in clinic.
引文
[1]谢新景,贾世青,陈涛.手术治疗椎间盘突出症的长期疗效及其影响因素[J].中外医学研究,2015,13(21):113-114.
[2]夏俊男.青年钙化型腰椎间盘突出症相关机制分析[D].长春:吉林大学,2013.
[3]徐辉,成鲁杰,姜培林,等.牵引下推拿为主治疗钙化型腰椎间盘突出症临床观察[J].中医学报,2013,28(8):1263-1264.
[4]赵学军,左玲,傅志俭,等.经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症[J].中国疼痛医学杂志,2013,19(1):8-12.
[5]赵伟,李长青,周跃,等.经皮椎间孔镜下TESSYS技术治疗腰椎间盘突出症[J].中国矫形外科杂志,2012,18(1):8-12.
[6]郭永兰.VAS评分在腰椎间盘突出症术后护理中应用[J].交通医学,2014,28(4):403-404.
[7]王飞,张玲芝,朱红芳.目标性干预护理对腰椎椎间融合术患者Oswestry功能障碍指数的影响[J].解放军护理杂志,2011,28(14):1-5.
[8]田纲,沈茂荣,梁伟国,等.改良内窥镜下PLIF联合经皮椎弓根螺钉固定治疗腰椎滑脱[J].中国骨科临床与基础研究杂志,2015,7(6):356-361.
[9]YEUNG AT,YEUNG CA.Minimally invasive techniques for the management of lumbar disc herniation[J].Orthop Clin North Am,2007,38(3):363-372.
[10]HOOGLAND T,VAN DEN BREKEL-DIJKSTRA K,SCHU-BERT M,et al.Endoscopic transforminal discectomy for recurrent lumbar disc herniation:aprospective,cohort evaluation of 262consecutive cases[J].Spine(Phila Pa 1976),2008,33(9):973-978.
[11]杨林,马学龙,石立刚,等.TESSYS技术与开放手术治疗腰椎间盘突出症的效果及安全性比较[J].中国当代医药,2013,20(36):49-50.
[12]李军,付强.经皮内镜椎板间入路治疗钙化型腰椎间盘突出症早期临床疗效分析[J].中国骨与关节杂志,2014,3(8):597-602.
[13]孙凤龙,章耀华,李强,等.经皮椎间孔镜技术治疗腰椎间盘突出症的临床疗效观察[J].中国临床医生,2016,44(2):75-78.
[14]陈旭,张如意,张琳,等.影像引导下经皮内窥镜腰椎间盘切除术治疗钙化型腰椎间盘突出症:41例报告[J].解放军医学杂志,2014,39(8):678-679.
[15]温志娟,王德强,曲明芬,等.椎间孔镜下TESSYS技术治疗伴钙化的腰椎间盘突出症的疗效[J].实用疼痛学杂志,2015,11(1):24-29.
[16]谭健,李平元,欧军,等.椎间孔镜技术治疗极外侧型腰椎间盘突出症的近期疗效观察[J].中国内镜杂志,2015,21(4):417-420.
[2]夏俊男.青年钙化型腰椎间盘突出症相关机制分析[D].长春:吉林大学,2013.
[3]徐辉,成鲁杰,姜培林,等.牵引下推拿为主治疗钙化型腰椎间盘突出症临床观察[J].中医学报,2013,28(8):1263-1264.
[4]赵学军,左玲,傅志俭,等.经皮椎间孔镜下髓核摘除术治疗腰椎间盘突出症[J].中国疼痛医学杂志,2013,19(1):8-12.
[5]赵伟,李长青,周跃,等.经皮椎间孔镜下TESSYS技术治疗腰椎间盘突出症[J].中国矫形外科杂志,2012,18(1):8-12.
[6]郭永兰.VAS评分在腰椎间盘突出症术后护理中应用[J].交通医学,2014,28(4):403-404.
[7]王飞,张玲芝,朱红芳.目标性干预护理对腰椎椎间融合术患者Oswestry功能障碍指数的影响[J].解放军护理杂志,2011,28(14):1-5.
[8]田纲,沈茂荣,梁伟国,等.改良内窥镜下PLIF联合经皮椎弓根螺钉固定治疗腰椎滑脱[J].中国骨科临床与基础研究杂志,2015,7(6):356-361.
[9]YEUNG AT,YEUNG CA.Minimally invasive techniques for the management of lumbar disc herniation[J].Orthop Clin North Am,2007,38(3):363-372.
[10]HOOGLAND T,VAN DEN BREKEL-DIJKSTRA K,SCHU-BERT M,et al.Endoscopic transforminal discectomy for recurrent lumbar disc herniation:aprospective,cohort evaluation of 262consecutive cases[J].Spine(Phila Pa 1976),2008,33(9):973-978.
[11]杨林,马学龙,石立刚,等.TESSYS技术与开放手术治疗腰椎间盘突出症的效果及安全性比较[J].中国当代医药,2013,20(36):49-50.
[12]李军,付强.经皮内镜椎板间入路治疗钙化型腰椎间盘突出症早期临床疗效分析[J].中国骨与关节杂志,2014,3(8):597-602.
[13]孙凤龙,章耀华,李强,等.经皮椎间孔镜技术治疗腰椎间盘突出症的临床疗效观察[J].中国临床医生,2016,44(2):75-78.
[14]陈旭,张如意,张琳,等.影像引导下经皮内窥镜腰椎间盘切除术治疗钙化型腰椎间盘突出症:41例报告[J].解放军医学杂志,2014,39(8):678-679.
[15]温志娟,王德强,曲明芬,等.椎间孔镜下TESSYS技术治疗伴钙化的腰椎间盘突出症的疗效[J].实用疼痛学杂志,2015,11(1):24-29.
[16]谭健,李平元,欧军,等.椎间孔镜技术治疗极外侧型腰椎间盘突出症的近期疗效观察[J].中国内镜杂志,2015,21(4):417-420.