微创腰椎间盘外科手术患者围手术期检验结果分析

Perioperative test results anaylsis in minimally invasive lumbar disc surgery

目的探讨微创腰椎间盘手术患者血清中C-反应蛋白(CRP)、红细胞沉降率(ESR)、白细胞计数(WBC)围手术期的变化规律。方法腰椎间盘突出症患者135例,分为A组(52例)套管微创类行内窥镜下髓核摘除术(MED)或切吸术(PLD),B组(48例)穿刺微创类臭氧消融术或射频消融术,对照组(35例)传统小开窗类直视下腰椎间盘髓核摘除术,分别在术前1d,术后1d,术后7d抽空腹静脉血检测ESR、CRP,手指末梢血检测WBC。结果 A组术后1d3项指标大多有阳性变化,7d后恢复正常,B组大多数3项指标无变化,对照组术后术后1d有阳性变化,7d后大部分恢复正常,持续增高1例为合并椎间隙感染。A组与B组,对照组与B组差异有统计学意义,A组和对照组差异无统计学意义。结论腰椎间盘突出症穿刺微创术围手术期CRP、ESR、WBC无明显变化,是真正意义上的微创治疗,手术创伤和反应小。

Objective To investigate the perioperative changes of C-reactive protein （CRP）,erythrocyte sedimentation rate （ESR）,white blood cell count （WBC） in the patients performed minimally invasive lumbar discs.Methods 145 cases of lumbar disc herniation were divided into group A（52 cases） performed minimally invasive endoscopic resetion of nucleus pulposus（MED） or discectomy （PLD）,group B（48 cases） performed minimally invasive puncture ozone ablation or radiofrequency ablation,and the control group （35 cases） performed the traditional small windowing lumbar discectomy umder direct vision,respectively.On 1d before surgery,1d and 7d after operation,the fasting venous blood was collected and detected for ESR,CRP and finger peripheral blood was collected for detecting WBC respectively.Results In group A,the majority had the positive change in above 3 indexes on postoperative 1d and recovered to normal on postoperative 7 d.In group B,3 indexes had no change.3 indexes had positive changes and recovered to normal in majority of the control group,1 cases with continuous increasing was complicated by intervertebral infection.There was statistical difference between the group A and the group B and between the control group and the group B.There was no statistical difference between the group A and the control group.Conclusion In puncture minimally invasive types（ozone catheter ablation,radiofrequency ablation） of lumber disc surgery,perioperative CRP,ESR and WBC have no significant change.Puncture types are truly minimally invasive therapy with little surgical trauma and little response.