脊柱椎间孔镜手术治疗腰椎间盘突出症的临床效果分析

Clinical analysis of spinal discoscopic surgery in the treatment of lumbar disc herniation

目的分析脊柱椎间孔镜手术治疗腰椎间盘突出症的临床效果。方法选取2016年6月~2017年8月我院收治的82例腰椎间盘突出症患者作为研究对象,按照电脑随机编码方法将其分为对照组(n=41)与观察组(n=41),对照组患者采用小切口手术治疗,观察组患者采用脊柱椎间孔镜手术治疗。比较两组患者的各项手术指标、评估结果。结果观察组患者的术中失血量为(20.25±6.34)ml,少于对照组[(65.59±10.34)ml],差异有统计学意义(P<0.01);观察组患者的手术用时为(59.68±3.32)min,切口长度为(1.21±0.28)cm,住院天数为(4.26±2.01)d,分别短于对照组[(75.54±8.15)min,(5.69±1.35)cm,(8.56±2.29)d],差异有统计学意义(P<0.01)。两组患者术前的直腿抬高角度、功能障碍指数(ODI)、视觉模拟(VAS)评分比较,差异无统计学意义(P>0.05)。两组患者术后的直腿抬高角度均高于术前,ODI、VAS评分均低于术前,差异有统计学意义(P<0.01);观察组患者术后的直腿抬高角度高于对照组,ODI、VAS评分均低于对照组,差异有统计学意义(P<0.05)。结论脊柱椎间孔镜手术治疗腰椎间盘突出症具有出血量少、手术时间短等优势,能够逐渐恢复患者的正常行动能力。

Objective To analyze the clinical effect of spinal discoscopic surgery in the treatment of lumbar disc herniation.Methods Eighty-two patients with lumbar disc herniation treated in our hospital from June 2016 to August2017 were selected as study subjects.They were divided into control group（n=41） and observation group（n=41） according to the computerized random coding method.Small incision surgery was used in the control group,and the observation group was treated with spine discoscopic surgery.The surgical indexes and evaluation results of the two groups of patients were compared.Results The intraoperative blood loss in the observation group was（20.25±6.34） ml,which was lower than that in the control group（[65.59±10.34] ml）,and the difference was statistically significant（P〈0.05）.The operation time of the observation group was（59.68±3.32） min,the incision length was（1.21±0.28） cm,the number of hospital stays was（4.26±2.01） d,which were respectively shorter than those of the control group（[75.54 ±8.15] min,[5.69±1.35] cm,[8.56±2.29] d）,and the differences were statistically significant（P〈0.05）.There were no significant differences in straight leg elevation,oswestry disability index（ODI）,and visual analogue scale（VAS） score before the operation in both groups（P〉0.05）.The angle of straight leg elevation of two groups after operation was higher than that before operation,the dysfunction index and pain scores after operation were lower than those before operation,and the differences were statistically significant（P〈0.01）.The angle of straight leg elevation in the observation group after operation was higher than that in the control group,the dysfunction index and pain scores were lower than those in the control group,and the differences were statistically significant（P 〈0.05）.Conclusion Spinal discoscopic surgery in the treatment of lumbar disc herniation has the advantages of less bleeding,shorter operative time,and can gradually restore the patient′s normal mobility.