经皮内镜钬激光椎间盘髓核摘除术的疗效观察与护理

Effectiveness and Nursing of Micro-endoscopic Discectomy for Acute Lumbar Disc Herniation

目的探讨经皮内镜钬激光椎间盘髓核摘除术的疗效与护理。方法选择25例经皮内镜钬激光椎间盘髓核摘除术患者为观察组,选取2005年2月至2006年2月病变程度相近的开放性手术患者35例为对照组,采用改良的Macnab标准评价两组患者疗效;并对两组患者的伤口长度、术中出血量、术后卧床时间、并发症发生率、住院天数等进行比较。结果两组患者近期疗效无统计学意义;观察组患者的伤口长度、术中出血量、术后卧床时间、住院天数明显低于对照组,比较有统计学意义(P<0.01);观察组并发症的发生率低于对照组,比较有统计学意义(P<0.01)。结论经皮内镜钬激光椎间盘髓核摘除术治疗腰椎间盘突出症的治疗效果满意,且创伤小、康复快,增加了患者的舒适度。

Objective To study the effectiveness and nursing of micro-endoscopic discectomy for acute lumbar disc herniation. Methods Sixty patients with lumbar disc herniation were divided into 2 groups. Twenty-five were treated with micro-endoscopic discectomy, another 35 cases were treated with conventional discectomy（control group）. Modified macnab criteria were employed to assess the outcomes in the 2 groups. The hospital stay, blood loss, recovery time, bed rest, complication and length of the incisions were compared between the 2 groups. Results There was no significant difference in the short-term outcomes between the 2 groups. The length of incisions, bed rest and hospital stay and blood loss in the test group were significantly lower than those in the control groups（ P〈0.01）. Besides, the test group had significantly less complication than the control group（ P〈0.01）. Conclusion Micro-endoscopic discectomy can achieve satisfactory effect in treatment of lumber disc herniation, with less trauma and faster recovory.