经皮椎间孔镜TESSYS技术对腰椎间盘突出症患者应激反应及治疗效果的影响

Effect of TESSYS technique on stress response and therapeutic effect in patients with lumbar disc herniation

目的探讨经皮椎间孔镜TESSYS技术对腰椎间盘突出症患者应激反应及治疗效果的影响。方法选择2012-05-2014-05收治的腰椎间盘突出症患者128例,随机分为观察组和对照组各64例,观察组接受经皮椎间孔镜TESSYS技术治疗,对照组接受常规椎板开窗髓核摘除术。比较两组手术情况、术后疼痛程度与机体功能状态、血清应激指标、临床疗效。结果随访2年,两组优良率比较,差异无统计学意义(P>0.05);观察组患者的手术时间明显长于对照组,切口长度、术后卧床时间、住院时间均明显低于对照组(P<0.05);术后1个月、术后2年,观察组腰痛视觉模拟评分(VAS)明显低于对照组(P<0.05);手术后3 d,观察组血清IL-6、TNF-α、hs-CR、肾素(Renin, R)、AngⅡ含量均明显低于对照组(P<0.05)。结论经皮椎间孔镜TESSYS技术有助于减轻腰椎间盘突出症手术创伤,降低应激反应与疼痛程度,促进机体功能恢复。

Objective To study the effect of TESSYS technique on stress response andtherapeutic effect in patients with lumbar disc herniation. Methods From May 2012 to May 2014,128 patients with lumbar disc herniation were divided into observation group and control group, with64 cases in each group. The observation group received surgical treatment according to percutaneoustransforaminal endoscopic TESSYS technology, the control group received conventional laminectomyopen window discectomy. The operation condition, pain degree, dysfunction degree, serum stressindicator, clinical effect were compared between the two groups. Results The patients were followedup for 2 years, there were no statistically significant difference in excellent and good rate（ P〉0.05）.The operation time of the observation group was significantly longer than that of the control group, theincision length, postoperative bed time and hospitalization time in the observation group weresignificantly lower than those in the control group （ t=12.600, 49.511, 32.955, 37.346, 29.539, P〈0.05）.At 1 month, 2 years after surgery, the VAS score of low back pain in the observation group wassignificantly lower than that in the control group（ P〈0.05）. At 3 days after operation, the serum levelsof IL-6, TNF- , hs-CR, renin and Ang II in the observation group were significantly lower than thosein the control group （P 〈0.05）. Conclusion TESSYS technique can helps to reduce the surgicaltrauma of patients with lumbar intervertebral disc protrusion, reduce stress response and pain degree,then promote the body function recovery.