经皮椎间孔镜与椎板开窗术治疗腰椎间盘突出症的效果比较

Effect comparison of percutaneous transforaminal endoscopic discectomy and fenestration discectomy in the treatment of lumbar intervertebral disc herniation

目的比较经皮椎间孔镜与椎板开窗术治疗腰椎间盘突出症的临床效果。方法选取2016年8月~2017年12月我院收治的94例腰椎间盘突出症患者作为研究对象,按照摸球法将其分为对照组(n=44)和研究组(n=50)。对照组患者采用椎板开窗术治疗,研究组患者采用经皮锥间孔镜治疗。比较分析两组患者的疗效、疼痛视觉模拟评分(VAS)、日本骨科学会(JOA)腰椎评分量表评分、术中出血量、平均住院时间等指标。结果研究组患者的优良率为98.00%,高于对照组(86.36%),差异有统计学意义(χ2=4.598,P<0.05)。两组患者治疗后的VAS评分均低于治疗前,JOA评分均高于治疗前,差异有统计学意义(P<0.05);研究组患者治疗后的VAS评分低于对照组,JOA评分高于对照组,差异有统计学意义(P<0.05)。研究组患者的术中出血量少于对照组,平均住院时间短于对照组,差异有统计学意义(P<0.05)。结论与椎板开窗术治疗比较,经皮椎间孔镜治疗腰椎间盘突出症的效果好,值得在临床中推广应用。

Objective To compare the clinical effect of percutaneous transforaminal endoscopic discectomy and fenestration discectomy in the treatment of lumbar intervertebral disc herniation.Methods A total of 94 cases of patients with lumbar intervertebral disc herniation treated in our hospital from August 2016 to December 2017 were selected as research objects and divided into the control group（n=44） and the study group（n=50） according to the method of touching the ball.The control group was treated with fenestration discectomy while the study group was treated with percutaneous transforaminal endoscopic discectomy.The results of indexes of curative effect,visual analogue scale（VAS） of pain,Japanese Orthopaedic Association（JOA） lumbar function score,intraoperative blood loss,and the average hospitalization time were compared and analyzed between the two groups.Results The excellent and good rate of patients in the study group was 98.00%,which was higher than that in the control group（86.36%）,and the difference was statistically significant（χ2=4.598,P〈0.05）.The VAS scores of patients after treatment of two groups were lower than those before treatment,the JOA scores were higher than those before treatment,and the differences were statistically significant（P 〈0.05）.The VAS score of after treatment in the study group was lower than that of the control group,the JOA was higher than that of the control group,and the differences were statistically significant（P〈0.05）.The intraoperative blood loss in the study group was less than that in the control group,the time of average hospitalization in the study group was shorter than that in the control group,and the differences were statistically significant（P〈0.05）.Conclusion Compared with fenestration discectomy,percutaneous transforaminal endoscopic discectomy in the treatment of lumbar disc herniation is effective,which is worthy of clinical application.