摘要
目的:观察经皮椎间孔入路内窥镜下椎间盘切除术治疗腰椎间盘突出症(LDH)患者的效果。方法:回顾性分析2022年5月至2023年5月该院收治的68例LDH患者的临床资料,根据手术方法不同将其分为对照组和观察组各34例。对照组给予椎板开窗髓核摘除术治疗,观察组给予经皮椎间孔入路内窥镜下椎间盘切除术治疗。比较两组围术期指标(切口长度、首次下床活动时间、住院时间、手术时间、术中出血量)水平、手术前后磁共振成像定量参数[髓核(NP)区、纤维环(AF)区的T2值、Tlrho值]、腰椎功能[Oswestry功能障碍指数(ODI)]评分、疼痛数字量表(NRS)评分、血清学指标[前列腺素E2(PGE2)、血栓素B2(TXB2)、肿瘤坏死因子-α(TNF-α)]水平和并发症发生率。结果:观察组切口长度、首次下床活动时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);两组手术时间比较,差异无统计学意义(P>0.05);术后3个月,两组NP区、AF区的T2值、Tlrho值均高于术前,但组间比较,差异无统计学意义(P>0.05);两组ODI、NRS评分均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05);术后7 d,两组血清PGE2、TXB2、TNF-α水平均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为2.94%(1/34),低于对照组的23.53%(8/34),差异有统计学意义(P<0.05)。结论:经皮椎间孔入路内窥镜下椎间盘切除术治疗LDH患者,可改善围术期指标水平,提高腰椎功能,减轻疼痛程度,降低血清学指标水平和并发症发生率,效果优于椎板开窗髓核摘除术治疗。
Objective:To observe effects of percutaneous transforaminal endoscopic discectomy in treatment of patients with lumbar disc herniation(LDH).Methods:The clinical data of 68 patients with LDH admitted to this hospital from May 2022 to May 2023 were retrospectively analyzed.According to different surgical methods,they were divided into control group and observation group,34 cases in each group.The control group was treated with fenestration discectomy,while the observation group was treated with percutaneous transforaminal endoscopic discectomy.The perioperative indexes(incision length,first ambulation time,hospitalization time,operation time,intraoperative blood loss)levels,the quantitative parameters of magnetic resonance imaging levels before and after the surgery[T2 value and Tlrho value of nucleus pulposus(NP)area and annulus fibrosus(AF)area],the lumbar function[Oswestry dysfunction index(ODI)]score,the pain digital scale(NRS)score,the serological indexes[prostaglandin E2(PGE2),thromboxane B2(TXB2),tumor necrosis factor-α(TNF-α)]levels,and the incidence of complications were compared between the two groups.Results:The incision length,the first ambulation time and the hospitalization time of the observation group were shorter than those of the control gr oup,the intraoperative blood loss was lower than that of the c ontrol group,and the differences were statistically significant(P<0.05).There was no significant difference in the operation time between the two groups(P>0.05).3 months after the surgery,the T2 values and Tlrho values of NP area and AF area in the two groups were higher than those before the surgery,but there were no significant differences between the two groups(P>0.05).The ODI and NRS scores of the two groups were lower than those before the surgery,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).7 days after the surgery,the levels of serum PGE2,TXB2 and TNF-αin the two groups were lower than those before the surgery,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 2.94%(1/34),which was lower than 23.53%(8/34)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Percutaneous transforaminal endoscopic discectomy for the LDH patients can improve the levels of perioperative indexes,improve the lumbar function,reduce the degree of pain,and reduce the levels of serological indexes and the incidence of complications.Moreover,it is superior to fenestration discectomy.
作者
宋磊磊
SONG Leilei(Department of Orthopaedics of Nanyang Central Hospital,Nanyang 473000 Henan,China)
出处
《中国民康医学》
2024年第17期54-57,共4页
Medical Journal of Chinese People’s Health
