骨科微创技术对腰椎间盘突出症的疗效及血清炎性因子水平的影响

Clinical Effect of Micro-invasive Orthopedics Surgery in Treatment of Lumbar Disc Herniation and Changes of Serum Inflammatory Factors

目的:探讨骨科椎间孔镜对腰椎间盘突出症的疗效及血清炎性因子水平的影响。方法:90例腰椎间盘突出症患者均分为对照组和治疗组,对照组采用开放手术治疗、治疗组采用骨科微创技术治疗;比较两组患者手术时间、住院时间、出血量、疼痛视觉模拟(VSA)评分及治疗效果,比较术前及术后第1、3及7天时两组患者血清C反应蛋白(CRP)、白介素-1β(IL-1β)、IL-6、IL-8及IL-10水平。结果:治疗组患者平均手术时间、住院时间、出血量及疼痛VSA评分显著低于对照组(P <0. 05),手术后第1、3及7天时,两组患者血清CRP、IL-1β、IL-6、IL-8及IL-10水平均显著高于治疗前(P <0. 05),对照组显著高于治疗组(P <0. 05),且均在术后第3天达到最高;治疗组患者与对照组患者优良率(88. 9%、91. 1%)比较,差异无统计学意义(P> 0. 05)。结论:骨科微创手术和传统开放手术治疗腰椎间盘突出症整体疗效基本一致,但微创治疗炎性反应轻微、对患者损伤程度较小、手术恢复时间快。

Objective:To investigate the effect of transforaminal endoscopic surgery in treatment of lumbar disc herniation and the change of serum inflammatory factors.Methods:A total of 90 patients with lumbar disc herniation were divided into control group and treatment group in equal number,control group received open surgery and treatment group received transforaminal endoscopic surgery.Observing following data of both groups:operation time,hospitalization time,blood loss,VSA score and treatment effect,and preoperative and postoperative serum levels of CRP,IL-1β,IL-6,IL-8 and IL-10 on 1d,3d and 7d.Result:The mean operative time,hospitalization time,intraoperative blood loss and VSA score of treatment group were significantly lower than that of control group(P>0.05);levels of CRP,IL-1β,IL-6,IL-8 and IL-10 of both groups were significantly higher than before treatment(P>0.05),data of control group were significantly higher than that of treatment group(P>0.05)and both groups reached peak value on 3d after surgery;rate of good cases comparison of both groups(88.9%,91.1%)showed no statistical difference(P>0.05).Conclusions:Overall effect of orthopedic micro-invasive treatment and traditional open treatment on lumbar disc herniation is basically the same,but minimally invasive treatment showed minor inflammatory reaction,less damage for patient and fast surgery recovery time.