可动式脊柱内镜技术治疗游离型腰椎间盘突出症

Removable spinal endoscopy for the treatment of free lumbar disc herniation

目的分析可动式脊柱内镜技术治疗游离型腰椎间盘突出症的临床效果。方法 125例游离型腰椎间盘突出症患者,均接受可动式脊柱内镜治疗,观察患者围术期指标及治疗效果,并观察患者术前、术后24 h、3个月腰痛及腿痛视觉模拟评分法(VAS)评分变化情况,比较患者术前及术后7 d焦虑自评量表(SAS)、抑郁自评量表(SDS)评分变化情况。结果 125例患者均成功完成手术,手术时间(61.53±16.28)min,术中出血量(70.49±31.87)ml,术后下床活动时间(1.95±0.75)d;患者术后24 h、3个月腰痛、腿痛VAS评分均明显低于术前,且术后3个月腰痛、腿痛VAS评分均明显低于术后24 h,差异具有统计学意义(P<0.05);患者术后7 d SAS、SDS评分均明显低于术前,差异具有统计学意义(P<0.05);术后6个月,125例患者治疗优良率为93.6%。结论可动式脊柱内镜技术治疗游离型腰椎间盘突出症临床效果良好,手术出血少,术后恢复速度较快,促使患者术后尽快提升生活质量。

Objective To analyze the clinical effect of removable spinal endoscopy for the treatment of free lumbar disc herniation. Methods A total of 125 patients with free lumbar disc herniation all were treated with removable spinal endoscopy. Observation were made on perioperative indexes, treatment effect, and changes of visual analogue scale（VAS） score of low back pain and leg pain in preoperation and postoperative 24 h and 3 months. Comparison were made on changes of self-rating anxiety scale（SAS） and self-rating depression scale（SDS） scores in preoperation and postoperative 7 d. Results All 125 patients successfully completed the operation, with operation time as（61.53±16.28） min, intraoperative bleeding volume as（70.49±31.87） ml, postoperative off-bed activity time（1.95±0.75） d. After operation, patients had obviously lower VAS score of low back pain and leg pain in postoperative 24 h and 3 months than before operation, and patients had obviously lower VAS score of low back pain in postoperative 3 months than that of postoperative 24 h. Their difference was statistically significant（P〈0.05）. Patients had obviously lower 7 d SAS and SDS score in postoperative 7 d than before operation, and the difference was statistically significant（P〈0.05）. The excellent-good rate of treatmentwas 93.6% in postoperative 6 months in 125 patients. Conclusion Removable spinal endoscopy shows excellent clinical effect in treating free lumbar disc herniation, with less operative bleeding and quicker postoperative recovery. It can promote the quality of life as soon as possible after operation.