经皮椎间孔镜技术在脱出型腰椎间盘突出症治疗中的应用
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摘要
目的探讨经皮椎间孔镜技术在脱出型腰椎间盘突出症治疗中的应用效果。方法将我院86例脱出型腰椎间盘突出症住院患者随机分为观察组和对照组,各43例。观察组应用经皮椎间孔镜治疗,对照组应用常规开放性手术治疗,比较两组的临床疗效、手术情况及不良反应发生情况。结果与对照组比较,观察组的手术时间、住院时间更短,术中出血量更少(P<0.05);两组不良反应发生率无显著差异(P>0.05);术后1、3个月,两组患者的VAS评分及Oswestry指数均较术前显著降低,且观察组患者术后1个月的VAS评分及Oswestry指数均显著低于对照组(P<0.05);观察组的临床疗效优良率显著高于对照组(P<0.05)。结论经皮椎间孔镜治疗脱出型腰椎间盘突出症不仅手术时间、住院时间短,术中出血量少、手术安全性好,而且更有利于疼痛症状的迅速改善和肢体功能的迅速恢复,临床疗效可靠。
Objective To investigate the application of percutaneous transforaminal endoscopic technique in the treatment of prolapsed lumbar disc herniation. Methods A total of 86 cases of prolapsed lumbar disc herniation in our hospital were randomly divided into observation group and control group, with 43 cases in each group. The observation group was treated by percutaneous transforaminal microscopy, and the control group was treated with conventional open surgery. The clinical efficacy, operation situation and adverse reactions of the two groups were compared. Results Compared with the control group, the observation group had shorter operation time, shorter hospital stays and less intraoperative blood loss(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P >0.05). At 1 and 3 months after surgery, the VAS score and Oswestry index in both groups were significantly lower than those before surgery, and the VAS score and Oswestry index of the observation group at 1 month after the surgery were significantly lower than those of the control group(P<0.05). The excellent rate of clinical curative effect in the observation group was significantly higher than that in the control group(P<0.05). Conclusion Percutaneous transforaminal endoscopic treatment of prolapsed lumbar disc herniation not only has shorter operation time, shorter hospital stay, less intraoperative blood loss and better surgical safety, but also be beneficial to the rapid improvement of pain symptoms and recovery of limb function, with reliable clinical efficacy.
Objective To investigate the application of percutaneous transforaminal endoscopic technique in the treatment of prolapsed lumbar disc herniation. Methods A total of 86 cases of prolapsed lumbar disc herniation in our hospital were randomly divided into observation group and control group, with 43 cases in each group. The observation group was treated by percutaneous transforaminal microscopy, and the control group was treated with conventional open surgery. The clinical efficacy, operation situation and adverse reactions of the two groups were compared. Results Compared with the control group, the observation group had shorter operation time, shorter hospital stays and less intraoperative blood loss(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P >0.05). At 1 and 3 months after surgery, the VAS score and Oswestry index in both groups were significantly lower than those before surgery, and the VAS score and Oswestry index of the observation group at 1 month after the surgery were significantly lower than those of the control group(P<0.05). The excellent rate of clinical curative effect in the observation group was significantly higher than that in the control group(P<0.05). Conclusion Percutaneous transforaminal endoscopic treatment of prolapsed lumbar disc herniation not only has shorter operation time, shorter hospital stay, less intraoperative blood loss and better surgical safety, but also be beneficial to the rapid improvement of pain symptoms and recovery of limb function, with reliable clinical efficacy.
引文
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[11]吴军,杨成伟,陈亮.经皮椎间孔镜技术治疗向上脱出型腰椎间盘突出症的疗效观察[J].中国基层医药,2017,24(16):2414-2416.
[12]王晋云.椎间孔镜技术与椎间盘镜技术对腰椎间盘突出症的治疗效果分析[J].健康之路,2017,16(6):67.
[13]马金辉,吴功.后路椎间盘镜手术与开放椎板开窗术治疗腰椎间盘突出的疗效比较[J].临床医学研究与实践,2017,2(28):49-50.
[14]吴昌林,丁培东.腰椎间盘突出症经皮椎间孔镜术中髓核摘除量相关性研究[J].临床医学研究与实践,2017,2(14):85-86.
[15]纪树青,吕达,李长签,等.椎间孔镜技术治疗腰椎间盘突出症的效果观察[J].中外医学研究,2017,15(15):7-8.
[16]舒剑臣,史可测,蒋俊威,等.经皮椎间孔镜治疗腰椎间盘突出症疗效分析[J].中华临床医师杂志:电子版,2015,9(21):4031-4033.
[2]周玮,李锐,谷会玲.腰椎间盘突出症健康教育[J].河北中医,2015,37(4):607-608.
[3]刘赫,彭碧艳,易伟宏,等.腰椎间盘突出症应用脊柱内窥镜技术治疗对降低疼痛及复发的作用分析[J].中国实用医药,2017,12(5):33-35.
[4]胡友谷.腰椎间盘突出症[M].2版.北京:人民卫生出版社,1995:269.
[5]徐城,杨晓秋,刘丹彦.常用的疼痛评估方法在临床疼痛评估中的作用[J].中国疼痛医学杂志,2015,21(3):210-212.
[6]刘绮,马超,伍少玲,等.Oswestry功能障碍指数评定慢性腰痛患者的效度分析[J].中国康复医学杂志,2010,25(3):228-231.
[7]DEZAWA A,MIKAMI H,SAIRYO K.Percutaneous endoscopic translaminar approach for herniated nucleus pulposus in the hidden zone of the lumbar spine[J].Asian J Endosc Surg,2012,5(4):200-203.
[8]徐仲林,蒋赞利.经皮椎间孔镜技术的发展、治疗范围、并发症及特点[J].东南大学学报,2015,17(3):452-455.
[9]金钟,雷光虎,梁冰,等.经皮椎间孔镜治疗腰椎间盘突出症[J].中国疼痛医学杂志,2013,19(7):446.
[10]黄克伦,滕红林,朱旻宇,等.经皮椎间孔镜下腰椎间盘摘除术并发症分析[J].中国骨伤,2017,30(2):121-124.
[11]吴军,杨成伟,陈亮.经皮椎间孔镜技术治疗向上脱出型腰椎间盘突出症的疗效观察[J].中国基层医药,2017,24(16):2414-2416.
[12]王晋云.椎间孔镜技术与椎间盘镜技术对腰椎间盘突出症的治疗效果分析[J].健康之路,2017,16(6):67.
[13]马金辉,吴功.后路椎间盘镜手术与开放椎板开窗术治疗腰椎间盘突出的疗效比较[J].临床医学研究与实践,2017,2(28):49-50.
[14]吴昌林,丁培东.腰椎间盘突出症经皮椎间孔镜术中髓核摘除量相关性研究[J].临床医学研究与实践,2017,2(14):85-86.
[15]纪树青,吕达,李长签,等.椎间孔镜技术治疗腰椎间盘突出症的效果观察[J].中外医学研究,2017,15(15):7-8.
[16]舒剑臣,史可测,蒋俊威,等.经皮椎间孔镜治疗腰椎间盘突出症疗效分析[J].中华临床医师杂志:电子版,2015,9(21):4031-4033.