经皮椎间孔镜与椎板开窗髓核摘除术治疗中年腰椎间盘突出症对比疗效分析

Comparative Analysis of Curative Effect of Percutaneous Intervertebral Foramen Microscopy and Discectomy for Middle-Aged Lumbar Disc Herniation

目的对比分析经皮椎间孔镜与椎板开窗髓核摘除术治疗中年腰椎间盘突出症患者的疗效。方法回顾性分析2015年1月—2017年12月住院的腰椎间盘突出症患者80例。按照手术方式分为常规开放性手术组(42例)和孔镜组(38例)。观察两组病员术前术后VAS、ODI、术中切口长度,手术时间,术中出血量,术后卧床,术后住院时间,住院费用及术后优良率等指标。结果两组病员术中切口长度,手术时间,术中出血量,术后卧床,术后住院时间,住院费用组间比较差异有统计学意义(P<0.05),除手术时间孔镜组长于常规组之外,其余孔镜组均低于常规组。VAS评分及ODI评分,术后组间比较差异有统计学意义(P<0.05),术前术后组内比较差异有统计学意义(P<0.05),两组病员术后VAS均明显低于术前,术后平均值孔镜组均低于常规组。两组患者均具有良好的优良率,组间比较差异无统计学意义(P>0.05)。结论在治疗中年腰椎间盘突出症的病员时,在熟练地掌握了孔镜技巧后经椎间孔镜髓核摘除术(PTED)是较好的选择。PTED近期疗效优于椎板开窗髓核摘除术(FD)组,并且住院费用花费更少,值得临床推广。

Objective To compare and analyze the curative effect of percutaneous fenestration and discectomy for middle-aged lumbar disc herniation.Methods A retrospective analysis was performed on 80 patients with lumbar disc herniation hospitalized from January 2015 to December 2017.According to the surgical method,the patients were divided into the conventional open surgery group and the hole mirror group,among which 42 patients were in the conventional open surgery group,and there were 38 cases in the hole mirror group.VAS,ODI,intraoperative incision length,operation time,intraoperative blood loss,postoperative bed rest,postoperative hospitalization time,hospitalization cost and postoperative good and good rate were observed in patients of the two groups before and after surgery.Results Patients in the two groups showed statistically significant differences in intraoperative incision length,operation time,blood loss volume,postoperative bed rest,postoperative hospitalization time,and hospitalization cost between the two groups(P<0.05).In addition to the operation time,the hole scope group was longer than the conventional group,while the other hole scope groups were lower than the control group.VAS score and ODI score showed statistically significant differences between the two groups after surgery(P<0.05),and between the two groups before and after surgery(P<0.05).Patients in both groups had significantly lower postoperative VAS than those in the preoperative group,and their postoperative mean values in the poroscopy group were lower than those in the control group.Patients in both groups had a good good and good rate,and the difference between the two groups was not statistically significant(P>0.05).Conclusion In the treatment of middle-aged workers with disc herniation,after journeying through the skills of orifices,this is a good choice.Journeyman has recently achieved better efficacy than the FD group,and is cheaper to hospitalize,and is worthy of clinical promotion.