经皮椎间孔镜治疗腰椎间盘突出的临床效果

Clinical effect of percutaneous transforaminal endosopic discectomy for the treatment of lumbar disc herniation

目的观察经皮椎间孔镜治疗腰椎间盘突出的临床疗效。方法 172例腰椎间盘突出患者按治疗方法分为两组:行椎间盘镜手术治疗为对照组(86例),行经皮椎间孔镜手术治疗为观察组(86例)。评估两组患者手术时间、切口长度、术中出血量、术后卧床时间、术后1、3、6个月的VAS评分和ODI以及术后6个月Nakai分级的优良率。结果与对照组比较,观察组的手术时间短、术中出血量少、切口小、术后卧床时间短,各项指标比较差异均有统计学意义(P<0.05)。两组患者术后1、3、6个月的VAS评分及ODI均较术前明显下降(P<0.05),术后各时段与对照组相比,观察组的疼痛症状减轻更明显,功能恢复更好(P<0.05)。术后6个月Nakai分级优良率:观察组为81.40%,对照组为62.79%,差异具有统计学意义(P<0.05)。结论经皮椎间孔镜手术在治疗腰椎间盘突出中具有切口小、出血少、术后恢复快的优点,临床疗效显著。

Objective To observe the clinical curative effect of percutaneous transforaminal endosopic discectomy （ PTED） in the treatment of lumbar disc herniation. Methods The 172 patients with lumbar disc herniation were di-vided into two groups according to the treatment methods： underwent PTED treatment as observation group （ 86 ca-ses） , microendoscopy discetomy treatment as control group （ 86 cases ） . These data were evaluated including two groups of patients with operation time, length of incision, intraoperative blood loss, postoperative bed time, preopera-tive and postoperative 1, 3, 6 months of VAS and ODI score,Nakai criteria classification in 6 months after surgery. Results Compared with the control group,observation group of patients was shorter operation time, less intraopera-tive blood loss, smaller incision, shorter postoperative bed time, the results showed significant differences （ P 〈0. 05）. Two groups of patients with postoperative 1, 3 and 6 months of VAS significantly decreased than the preopera-tive （P〈0. 05）. Each period compared with the control group with phase, postoperative observation group of patients with pain symptoms relieved more obviously （ P〈0. 05 ） . In each period of the ODI score, observation group was lower than control group （P〈0. 05）, the function of the patients recovery was better than the control group. Nakai classification excellent-good rate： the observation group patients was 81. 40%, the control group was 62. 79%, the difference was significant （P〈0. 05）. Conclusions PTED in the treatment of lumbar disc herniation has the advan-tages of small incision, less bleeding and quick recovery, the clinical curative effect is distinct.