摘要
目的探讨经皮椎间孔镜技术(percutaneous transforaminal endoscopic discectomy,PTED)治疗肥胖患者合并腰椎间盘突出症(lumbar disc herniation,LDH)的安全性、有效性。方法回顾分析作者医院2018-01/2019-12月采用PTED治疗LDH的临床资料,其中30例肥胖患者纳入肥胖组,42例体质量指数(body mass index,BMI)正常患者纳入非肥胖组。收集、比较两组患者的围手术期资料,手术效果采用Oswestry功能障碍指数(Oswestry disability index,ODI)和疼痛视觉模拟评分(visual analogue scale,VAS)及改良的MacNab标准进行评估。结果72例患者都顺利完成手术,术中无硬脊膜破裂、神经根损伤和血管破裂等并发症发生。肥胖组术中的透视次数、工作通道放置时间及手术时间大于非肥胖组(P<0.05),两组患者术后住院时间无统计学差异(P>0.05)。两组患者的术后ODI及VAS评分随时间推移均显著减少(P<0.05),两组患者的术后VAS及ODI评分无统计学差异,不同处理方式与不同时间不存在交互作用(P>0.05)。根据改良的MacNab评分标准,肥胖组26例患者优良(86.67%),非肥胖组38例患者优良(90.48%),优良率对比无统计学差异(P>0.05)。结论PTED技术治疗肥胖患者LDH是安全有效的,同时应注意术后康复训练。
Objective To testify the safety and effectiveness of percutaneous transforaminal endoscopic discectomy(PTED)technology in treating obese patients with lumbar disc herniation(LDH).Methods A retrospective research was conducted on patients with LDH who received PTED from January 2018 to December 2019 in author′s hospital.A total of 30 obese patients were included in obesity group,and 42 patients with normal body mass index(BMI)were included in the non-obesity group.Perioperative data was collected and compared between the two groups.The surgical outcomes were evaluated by Oswestry disability index(ODI),visual analogue scale(VAS)and modified MacNab criteria.Results A total of 72 patients′operations were successfully performed without complications,such as durotomy,nerve root injury and vascular injury.The frequency of intra-operative fluoroscopy,cannula placement time,and operation time in obesity group were more than those in non-obesity group(P<0.05),meanwhile,length of postoperative hospital stay was not significantly difference between the two groups(P>0.05).Post-operative ODI and VAS scores significantly decreased over time(P<0.05).There was no statistical difference in VAS and ODI scores between the two groups after operation and there was no interaction between different treatments and different time(P>0.05).According to the modified MacNab standard,26 patients(86.67%)of obesity group had excellent results,and that of non-obesity group were 38 patients(90.48%),which had no significant difference(P>0.05).Conclusion PETD technology is safe and effective in treating obese patients with LDH,meanwhile,careful attention should be given postoperative rehabilitation training.
作者
朱方强
姚亚伟
熊承杰
姚志鹏
杨赛
徐峰
ZHU Fangqiang;YAO Yawei;XIONG Chengjie;YAO Zhipeng;YANG Sai;XU Feng(Graduate Institute,Wuhan University of Science and Technology School of Medical,Wuhan Hubei 430070,China)
出处
《华南国防医学杂志》
CAS
2021年第11期806-809,共4页
Military Medical Journal of South China
基金
武汉市科技计划项目(2019020701011423)。
关键词
腰椎间盘突出症
经皮椎间孔镜技术
肥胖
Lumbar disc herniation
Percutaneous transforaminal endoscopic discectomy
Obesity
