显微内镜腰椎间盘摘除术对患者血浆前列腺素E2和β内啡肽的影响

Effect of endoscopic microsurgery lumbar discectomy on plasma levels of PGE2 and β-EP

目的探讨显微内镜腰椎间盘摘除术对患者血浆前列腺素E2（PGE2）和β内啡肽（β—EP）的影响。方法102例腰椎间盘突出症患者随机分为两组，对照组51例，采用传统手术；观察组51例，采用显微内镜腰椎间盘摘除术。比较两组的手术切口、手术时间、术中出血量、术中引流量、下床时间、术后住院时间。术前及术后3个月测定血浆PGE2和β-EP。VAS和ODI进行评分。结果观察组在手术切口、手术时间、术中出血量、术中引流量、下床时间、术后住院时间方面均少于对照组（P〈0．05，P〈0．01）。两组在术后第1、3、7天VAS评分较术前均明显降低（P〈0．01），并且与对照组同期比较，观察组降低更明显（P〈0．05）。两组术后1年观察组ODI明显低于对照组（P〈0．05）。对照组术后并发症发生率为25．5％，观察组发生率为21．6％，两组比较差异无统计学意义（P〉0．05）。两组术后血浆PGE2均有明显降低，并且观察组降低更明显（P〈0．05）；两组术后血浆β—EP均有明显升高，并且观察组升高更明显（P〈0．05）。结论显微内镜腰椎间盘摘除术可以更明显减轻腰椎间盘突出患者的炎症状态而改善病情，减轻疼痛。

Objective To study the effect of endoscopic microsurgery lumbar discectomy on plasma levels of prostaglandin E2 （PGE2） and β endorphin （β-EP）. Methods One hundred and two patients with lumbar disc herniation were randomly divided into two groups, the control group （51 cases） and the observtion group （51 cases）. The patients in the control group were operated through traditional surgery, while the patients in the observation group were operated through endoscopic microsurgery lumbar discectomy. Surgical incision, operative time, blood loss, intraoperative drainage, bed time, postoperative hospital stay were compared. Plasma PGE2 and β-EP levels were detected before operation and three months after operation. VAS and ODI scores were evaluated. Results Incision, operative time, blood loss, intraoperative drainage, bed time and postoperative hospital stay in the observation group were less than those in the control group （ P 〈 0. 05, P 〈 0. 01 ）. In both groups, the postoperative VAS scores 1,3,7 days were significantly lower than the preoperative VAS score（ P 〈 0. 01 ）. And compared with the same date, that in the observation group decreased more significantly （ P 〈 0. 05 ）. One year postoperative ODI score in observation group was significantly lower than that in the control group （ P 〈 0. 05 ）. The incidence of postoperative complications was 25.5% in the control group and 21.6% in the observation group, there was no significant difference between the two groups（ P 〉 0.05 ）. Postoperative plasma PGE2 levels were significantly increased, and those in the observation group were decreased more significantly （ P 〈 0. 05 ）. Postoperative plasma β-EP levels were significantly increased, and those in the observation group were increased more significantly （ P 〈 0. 05 ）. Conclusions Endoscopic microsurgery lumbar discectomy can improve the plasma levels of PGE2 and β-EP.