腰椎间盘镜可视性对椎间盘术后临床疗效的影响

Clinical observation of the visibility of microendoscpic operation on postoperation effect

目的探讨腰椎间盘镜可视性对椎间盘镜术后临床疗效的影响。方法选择单节段腰椎间盘镜手术患者60例，其中男45例，女15例，平均35．8岁。随机分为：试验组（30例）和对照组（30例）。试验组患者观看整个手术操作过程，并接受手术医生解释。对照组患者却不观看手术操作进程。术后效果按Nakai分级，并针对患者对手术疗效的理解、认知和信心程度等心理特点，设立并观察：手术认识指数、手术信心指数和手术满意指数，并与术后疗效进行比较。结果按Nakai分级术后6个月的优良率93．4％较术后1月优良率73．3％有显著提高（P〈0．05）。试验组患者对于手术认识度、手术可信度都较对照组显著增高（P〈0．05）。结论腰椎间盘镜的可视性优点，虽然对客观的临床手术结果无直接影响，但通过患者对手术操作过程的了解，对患者了解和相信手术、相信医生，打消顾虑和树立信心具有一定临床意义。

Objective To investigate the influence of the visibility of Microendoscpic（MED） operation on postoperation effect . Methods Sixty patients including 45 cases of man, 15 cases of women, with the average of 35.8 years old received single segmental MED operation and were separated as experiment group （30 cases） and control group （30 cases） randomly. In experiment group, the patients watch the whole operation process and received the explanation of the treatment from their doctors. In control group, they were not allowed watching and were just simply informed that the operation was successful. Nakai evaluation was employed to determine the operation effect. Operation acknowledgment index, confidence index, and satisfaction index were introduced to compare the postoperation effect according to the patients＇ understanding about their operation, their acknowledgment and confidence. Results The excellent an good rate in half a year raised obviously compared with 1 month postoperation with Nakai evaluation. The patients in experiment group showed clear increase in the acknowledgment and trust of the operation compared with the control group. Conclusion MED operation has no obvious influence on clinical effect, but it has the advantage of visibility which is much significant in strengthening patients＇ confidence and trust in their surgeons, and dispelling apprehension through the acknowledgment of operation process.